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What Causes High Liver Enzymes After HCV Treatment?
Question: High liver enzymes after HCV treatment
With sovaldi, peg Interferon, and Ribavirin. HCV undetected still at 9 months, but LFT still high.
With sovaldi, peg Interferon, and Ribavirin. HCV undetected still at 9 months, but LFT still high.
Brief Answer:
Some second pathology could be associated!
Detailed Answer:
Hi! thanks for your health query!
In fact, all patients with HCV infection show this kind of problems, according to my experience.
Mild to moderate elevation in the liver enzymes is common and this could be related to latent disease (the virus not dividing ), related to medicines taken and sometimes associated diseases like biliary infection, gall bladder inflammation, pancreatic problems, auto-immune hepatitis etc.
Anyway, I would like to know:
1. genotype of your HCV
2. Did you get a liver biopsy report?
3. do you do PCR for HCV detection?
Please give your feedback,
regards,
Some second pathology could be associated!
Detailed Answer:
Hi! thanks for your health query!
In fact, all patients with HCV infection show this kind of problems, according to my experience.
Mild to moderate elevation in the liver enzymes is common and this could be related to latent disease (the virus not dividing ), related to medicines taken and sometimes associated diseases like biliary infection, gall bladder inflammation, pancreatic problems, auto-immune hepatitis etc.
Anyway, I would like to know:
1. genotype of your HCV
2. Did you get a liver biopsy report?
3. do you do PCR for HCV detection?
Please give your feedback,
regards,
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Geno 1a
Hcv test cobas r Taqman r
Biopsy on 4/16/15
Last biopsy on September 2013 3 mos before start of sovaldi, peg interferon, RIBA treatment. Mild stage 2
Felt good before treatment,1 week into I
Felt terrible all treatment symptoms plus
Liver was swelling. After 12 weeks of that
Symptoms eased a little and 2 weeks after treatment I started itching,abdominal pain, joint pain that is real bad even today and I broke out in this real bad form of VITILIGO my normal complection darkened and then white spots all over face neck and arms, had to leave work on medical because of after treatment symptoms I either go back to work within
2 months or I will be forced into early
Retirement.
Hcv test cobas r Taqman r
Biopsy on 4/16/15
Last biopsy on September 2013 3 mos before start of sovaldi, peg interferon, RIBA treatment. Mild stage 2
Felt good before treatment,1 week into I
Felt terrible all treatment symptoms plus
Liver was swelling. After 12 weeks of that
Symptoms eased a little and 2 weeks after treatment I started itching,abdominal pain, joint pain that is real bad even today and I broke out in this real bad form of VITILIGO my normal complection darkened and then white spots all over face neck and arms, had to leave work on medical because of after treatment symptoms I either go back to work within
2 months or I will be forced into early
Retirement.
Brief Answer:
You have chronic hepatitis C, controlled but not cured!
Detailed Answer:
Well, you are under the correct treatment protocol and as per guidelines,
Normal LFT is defined as 'All levels are within the normal range.' whereas Abnormal report is defined as 'One or more levels are outside the normal range...'
Abnormal liver function tests may indicate that your liver is inflamed or is not working normally. This can be a sign that you have a viral infection though the virus are not growing in number, they are harming your liver cells slowly and you need treatments, as directed....
(FOR YOUR KNOWLEDGE SAKE:) Liver enzyme levels that remain above normal for longer than 6 months, which is evidence of chronic infection.
When hepatitis C treatment is working, the virus will become undetectable within four to 12 weeks and will remain that way throughout treatment. People are considered cured when they have achieved what is known as a sustained virologic response (SVR), or continuation of this undetectable status, 12 to 24 weeks after completing therapy.
Wishing you good health,
You have chronic hepatitis C, controlled but not cured!
Detailed Answer:
Well, you are under the correct treatment protocol and as per guidelines,
Normal LFT is defined as 'All levels are within the normal range.' whereas Abnormal report is defined as 'One or more levels are outside the normal range...'
Abnormal liver function tests may indicate that your liver is inflamed or is not working normally. This can be a sign that you have a viral infection though the virus are not growing in number, they are harming your liver cells slowly and you need treatments, as directed....
(FOR YOUR KNOWLEDGE SAKE:) Liver enzyme levels that remain above normal for longer than 6 months, which is evidence of chronic infection.
When hepatitis C treatment is working, the virus will become undetectable within four to 12 weeks and will remain that way throughout treatment. People are considered cured when they have achieved what is known as a sustained virologic response (SVR), or continuation of this undetectable status, 12 to 24 weeks after completing therapy.
Wishing you good health,
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
So my new Gastro Dr believes hepc is out
Of the equation because of all the undetected testing and we're looking into
Auto immune. Will the biopsy tell if there
Is Hepc?
Thanks in advance, Al
Of the equation because of all the undetected testing and we're looking into
Auto immune. Will the biopsy tell if there
Is Hepc?
Thanks in advance, Al
Brief Answer:
Definitely!
Detailed Answer:
Hi! thanks for your updates!
Liver biopsy has definite criteria to differentiate HpC from auto-immune hepatitis; however, immunohistochemistry on the biopsy tissue for HCV antibody is required; please share the biopsy findings with me if necessary! I specialize in this subject and I routinely do liver biopsies also.
Regards,
Definitely!
Detailed Answer:
Hi! thanks for your updates!
Liver biopsy has definite criteria to differentiate HpC from auto-immune hepatitis; however, immunohistochemistry on the biopsy tissue for HCV antibody is required; please share the biopsy findings with me if necessary! I specialize in this subject and I routinely do liver biopsies also.
Regards,
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Hello, Reported on 4/12/15 thru LabCorp
Hcv Not Detected.
Actin smooth muscle antibody 58
0-19 Negative
20-30 weak positive
>30 strong positive
ANA w/Reflex if positive
ANA direct. Negative
Liver-kidney Micrsomal Ab= 6.4 ab
0-20 Neg
20.1-24.9 Equivocal
24.9>pos
Alb 4.04
T protein 9.15
Alk 378.0
Ast 83.0
Alt 153.0
T Bili 1.2
D Bili 0.600
Biopsy shows mild Inflamation.
What do you think about this.
Thanks,Al
Hcv Not Detected.
Actin smooth muscle antibody 58
0-19 Negative
20-30 weak positive
>30 strong positive
ANA w/Reflex if positive
ANA direct. Negative
Liver-kidney Micrsomal Ab= 6.4 ab
0-20 Neg
20.1-24.9 Equivocal
24.9>pos
Alb 4.04
T protein 9.15
Alk 378.0
Ast 83.0
Alt 153.0
T Bili 1.2
D Bili 0.600
Biopsy shows mild Inflamation.
What do you think about this.
Thanks,Al
Brief Answer:
I would think of auto-immune hepatitis....!
Detailed Answer:
Hi! thank you for the follow-up!
Therefore, now you have raised anti-SMA, Globulin, AST, ALK, ALT and slightly bilirubin also especially unconjugated; therefore, there is evidence of hepatitis or hepatic injury but the biopsy/serology do not support Hepatitis C !
A large increase in the blood titer of SMA or actin antibody is usually due to autoimmune hepatitis. The SMA autoantibody may also be found in other conditions, such as primary biliary cirrhosis (PBC), infectious mononucleosis, hepatitis C and some cancers.
In chronic hepatitis C the biopsy report is classical not only just mild inflammation; therefore, I would think of auto-immune hepatitis in your case.
Please discuss it also with your primary doctor as there are clinical parameters also.
Regards,
I would think of auto-immune hepatitis....!
Detailed Answer:
Hi! thank you for the follow-up!
Therefore, now you have raised anti-SMA, Globulin, AST, ALK, ALT and slightly bilirubin also especially unconjugated; therefore, there is evidence of hepatitis or hepatic injury but the biopsy/serology do not support Hepatitis C !
A large increase in the blood titer of SMA or actin antibody is usually due to autoimmune hepatitis. The SMA autoantibody may also be found in other conditions, such as primary biliary cirrhosis (PBC), infectious mononucleosis, hepatitis C and some cancers.
In chronic hepatitis C the biopsy report is classical not only just mild inflammation; therefore, I would think of auto-immune hepatitis in your case.
Please discuss it also with your primary doctor as there are clinical parameters also.
Regards,
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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