{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:14:55Z","timestamp":1783466095577,"version":"3.55.0"},"reference-count":10,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8,3]]},"abstract":"<jats:p>The aim of this controlled cross-sectional study was to assess the clinical validity of elevated values of three clinically relevant transferase enzymes (aspartate transaminase [AST], alanine transaminase [ALT], and gamma-glutamyl transferase [GGT]) induced by imported infectious diseases (IDs) seen among patients consulting the Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (from 1999 to 2014) after being in the sub-\/tropics. Data sets of 14,559 diseased German travelers returning from Latin America (2,715), Africa (4,574), or Asia (7,270) and of 1,536 healthy controls of German origin without recent travels were analyzed. Among the cases, the proportions of those with elevated values of AST (7.8%) and of ALT (13.4%) were significantly larger than among controls (4.0% and 10.6%, respectively), whereas for GGT, no significant difference was found (cases: 10.0%; controls: 11.4%). The study identified IDs with significantly larger proportions of both AST and ALT (hepatitis A [100%\/100%], cytomegalovirus [CMV] infection [77%\/81%], chronic hepatitis C [67%\/67%], infectious mononucleosis [65%\/77%], typhoid fever [50%\/50%], cyclosporiasis [45%\/66%], dengue fever [43%\/35%], malaria [20%\/27%], and rickettsiosis [20%\/24%]), of AST alone (paratyphoid fever [42%]), of ALT alone (giardiasis [20%]), and of GGT (hepatitis A [100%], infectious mononucleosis [71%], CMV infection [58%], rickettsiosis (20%], and dengue fever [19%]). The study demonstrates that the determination of AST and ALT among travelers returning from the sub-\/tropics has a high clinical validity, as their elevated values are typically caused by several imported viral, bacterial, and protozoan IDs, whereas no additional clinical validity was found by the determination of GGT.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0224","type":"journal-article","created":{"date-parts":[[2016,5,24]],"date-time":"2016-05-24T03:14:43Z","timestamp":1464059683000},"page":"481-487","source":"Crossref","is-referenced-by-count":8,"title":["Elevated Values of Clinically Relevant Transferases Induced by Imported Infectious Diseases: A Controlled Cross-Sectional Study of 14,559 Diseased German Travelers Returning from the Tropics and Subtropics"],"prefix":"10.4269","volume":"95","author":[{"given":"Karl-Heinz","family":"Herbinger","sequence":"first","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Hanus","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"Felbinger","sequence":"additional","affiliation":[{"name":"2Department of Anesthesiology, Critical Care and Pain Medicine, Neuperlach Medical Center, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Weber","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Beissner","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"von Sonnenburg","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"L\u00f6scher","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisela","family":"Bretzel","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Dieter","family":"Nothdurft","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hoelscher","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."},{"name":"3German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Alberer","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Principles of Biochemistry","author":"Horton","year":"2005"},{"key":"ref2","series-title":"Nucleic Acids Res","first-page":"D439","article-title":"BRENDA in 2015: exciting development in its 25th year of existence","volume":"43","author":"Chang","year":"2015"},{"key":"ref3","series-title":"Enzyme Nomenclature","author":"Nomenclature Committee of the International Union of Biochemistry and Molecular Biology (NC-IUBMB)","year":"2015"},{"key":"ref4","series-title":"Harrison's Principles of Internal Medicine","year":"2011"},{"key":"ref5","series-title":"Principles and Practice of Infectious Diseases","year":"2015"},{"key":"ref6","series-title":"Tropenmedizin in Klinik und Praxis","year":"2010"},{"key":"ref7","series-title":"Am J Trop Med Hyg","first-page":"757","article-title":"Spectrum of imported infectious diseases: a comparative prevalence study of 16,817 German travelers and 977 immigrants from the tropics and 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