Hey Zilkster,

I think your hepa doctor is correct "to much analysis....."

Alcohol, Tylenol, some supplements, fatty liver and other things or medications can cause it to go up.

If your test come out UND then eat better and exercise buddy.

I wanted to chime in and say congratulation Zlikster !! I to have had a few bars of chocolate over the last while and try to fit both the healthy food and a couple of sweets just to make me feel like the old me.  lol  And as I mentioned to the others try to get out for a walk in a quite place. And Dominique  I hope you are feeling better. I just received an email from my Hepto saying that yes the cirrhosis can be reversed so a little confused from all that I have read but we are all on the right track and striving to get better. Take care all !!

Hi  Zlikster

As my doc said : the cured ones do not care about their healthy living any more ! so do'nt be too desapointed to see your Alat going up : your lever does not like sugar, fat etc. BUT I do understand you needed a brake from diet, but come back fast to healthy food, your liver is begging for it :)

Thanks for your kind words, Zlikster, I too beleive you will be 0 VL and 5 ALAT in a few month :)

Cheer

Dominique

ALT of 35 sounds cool Do :) Hows your benzo withdrawal symptoms going?

i hope you and Malcolm reverese cirrhosis as much as possible!i wanna see you both at least F1 :)

My hepa is pretty relaxed round this ALT spike, me on other hand i can't sleep properly since i got this results...anxiety is bulding up, I want that SVR12 "badge" :/ I wonder whats the +- precentage that can be off on enzymes counts in labs?

look at my ALT chronology (12-48 normal range):

pre tx - ALT 44

pre tx - ALT 64

pre tx - ALT 49

pre tx - ALT 50

pre tx - ALT 61

tx w1 - ALT 40

tx w8 - ALT 21

tx w11- ALT 25

tx w12- ALT 21

tx w14- ALT 20

tx w17- ALT 24

eotw1- ALT 21

eotw13-ALT 53

other hope is, since i have started to eat well again (espec sweets) and gained 7kg back, that fatty liver ,which was probably caused by GT3, is still not sorted out and that might cause spikes in ALT, but then again...pure logic comes to mind:  ALT levels 40-64 with hcv, with interferon 20-25,  post interferon 53. I doubt interferon was killing ALT spikes from fatty liver? meh...as my hepa said "too much analysis, causes paralysis" ;)

Thinking of trying strict diet again, no matter what PCR results i get. I wanna get those ALT levels down.

cheers!

Thanks a lot Malcom, you'r the first one to give me an honnest answer to that question. I have the feeling that French docs put lot of pressure on us to make sure one will not go back to old habits like drinking, smoking herbs, fatty foods, etc. after  they are told the virus is gone. So docs are keeping telling us about death at the corner, etc. They ask cirrhotic patients to have an ultra sound every 3 month, even if they  have been cured for years, which seems a lot to me.

One told me there is more cured patients who die from liver cancer than patients with HVC, because the cured ones do not care about their healthy living any more.

Once that said, they are really hard on us : doc told me once again the other week to never forget that my liver is verrrrrrry ill. Came back home with the feeling it's hopless to fight to get cured..   

Sorry to have use your thread Zlikster to get more informations from Malcom

Do

Hi Do,

I do not have any more virus replicating in my hepatocytes, causing cell damage and death.  However, cirrhosis is a separate disease with many different causes.  Eliminating the cause can stop cirrhosis progressing and hopefully start to resorb fibrous tissue, fibrous bands and the unwanted septae. As the normal liver architecture of the liver is lost in cirrhosis, the liver forms a lot of regenerative nodules. Some of these outstrip their blood supply and hepatocytes die, releasing the liver enzymes, particularly ALT. This is all part of a dynamic struggle by the liver, to try to produce as much functional liver tissue as possible. Patients with F3 or F3-4 may be able to end up with a fairly normal liver. My Fibroscan reading was high, so I probably have a lot of fibrosis. My odds of reversing this are slim, but every little bit helps. I'll wait for a year and then get another Fibroscan. If the reading drops I'll be happy. The problem of constant regeneration of hepatocytes is the reason for the increased risk of HCC so I'll have 6 monthly imaging.  SVR greatly reduces the rate of cell division, so the risk of HCC drops 10-fold.

One of the most beneficial results of SVR is decrease in the portal venous pressure. This is what leads to varices , splenomegaly etc. During HCV infection, the liver tries to restrict the flow of blood from the bowel, giving it less work to do. Connective tissue forms around the walls of the portal vein branches, causing them to narrow, thus increasing pressure. As the liver recovers and does not have the constant insult from the virus ( over 1 trillion relications of virus occur in heaptocytes each day!), the liver can deal with normal portal blood flow and the portal vein branches dilate again. This has been well shown in biopsies pre and post SVR. 

By the way, an ALT of 35 is excellent, and your liver may recover fully. Cheers.

Hi Doc Malcom,

I have a question for you :

Cirrhosis means our liver has lot of scar tissue, eventually preventing the liver from functioning properly, yes ? but it does not destroy the liver by it self, yes ? it was the HVC which was doing so. So why the ALT are still up some time while there is no more virus ?

Mine are 35 and I was surprised at first as I thought it would have dropped to 5 or 10 at most ?

Thanks for the sharing Malcom, it made me feel better

DO

Hi Zlikster,

My ALT levels to reassure you: Normal is 5-40 U/L for my Lab.

SOT: 119

EOT:  71

EOT +2w: 51

EOT +4w: 48

EOT +8w: 88

EOT +12w: 70

EOT +28w: 53

Remember I still have cirrhosis despite SVR. Maybe they will drop to normal in a year or so, but the level is really of no concern to me anymore. Cheers.

thanks folks for kind words :) i just do not like ALT numbers jumping to same pre-tx levels...and i did not fully understood my hepa, explaining why should i not take PCR now yet one @ 24w, tho i said it's just for my peace of mind sake, she was mentioning some post-tx kinetic viral activity? I thought there is no virus activity left if you are UND? Maybe i am wrong, maybe there is some activity in the liver...

@Malcolm, mind posting you ALT levels if you are following em EOT until now?

as for ultrasound, before i had notion about being infected with hcv (cca 3 years ago), one specialist ultrsound doctor asked me about hepatitis (when he saw fatty liver), so i do not want to say ultrasound is totally bollocks ;) FibroScan is about to arrive in Sarajevo finally, hepa told me it's on the customs atm! Good news for all folks in Bosnia :)

i am just lately in lot of stress with family issues, so this ALT results ain't helping ease the stress at all, tho i am prepared if i did indeed relapsed strategy on how to deal with hcv until new DAA combos arrive that work on GT3. I am not scared, just stressed i guess :)

thanks again, hope everyone on this forum (SVR crew, post tx, shooters, clinical trialists crew, relapsers, nonresponders) are doing ok :) i have some internet issues back home, waiting to get fixed, will get more on forum to see hows everyone doing soon :)

they are all right, the anxiety of worrying about are results is being human and we all went through this treatment that really altered are lives and healed  our bodies to some extent fiber scan results were positive and alt and ast still are only the day the blood work was done.  ans normally we really never followed this or for me was aware of this since I started treatment, it is hard but wait for the big test at six months post and live one day at a time and enjoy the moment

bill emma and raven

Hi Zlikster,

Like Malcom said, not to worry about Alt changes, it did the same for me and I am still UND.

That 'bad feeling" some thing wrong is happening, WE ALL HAVE IT one way or another, however,  we may understand by the end it does not mean anything excepted we are a lot worried.

I would not trust ultrasound too much : mines always say liver and all around are totally fine and normal, .. however fibroscan said 8 months ago 16 UPK (cirrhosis) !

Hi Zlikster,

Don't worry man. My ALT went up between EOT and 8 weeks post, and I was certain I'd relapsed. By 12 weeks post-Rx it had dropped again, and I stayed Undet. Also, don't be concerned about your Ultrasound findings. If a sonographer told me I had slight enlargement of one liver lobe and some slight fatty change, I'd tell her/him 'you're dreaming'. Ultrasound is not that exact. Just relax and get your 12 week VL- it'll be Undetected!! Cheers.

Oh my Zlikster-you just cannot get a break.  Sending positive thoughts your way...

Good luck, i know about bad feelings. Couple weeks ago on my 12 week post VL test i had a real bad feeling. But it came back UND..so forget the bad bad feelings, go by the facts.

I know, easier said than done..

Sorry to hear you're having to worry about that. It must be difficult to consider, especially this soon. Good luck on your results tomorrow! I'll keep my fingers crossed!

Hi folks!

i have been offline for few days...

just got back from full body check and talked with my hepa...blood counts are back fully (RBC,WBC,etc), but then scary thing showedup. ALT levels are back to it's pre tx numbers. ALT 53 (48 upper limit). I have had 45-70 ALT past 6 years, and while on tx i hade 20-30 ALT. :( My hepa told me not to do new PCR until 24w post tx, but i can't wait that long to see did hcv reacitivated. I am going (on my own) to do PCR tomorrow.

I hope it's just fatty liver expression, but i got a bad feeling...after first interferon shot, my ALT halved and stayed for whole tx and 2 weeks post tx, now it's back to pre tx levels. My hepa wasn't that worried. On ultrasound there was some light liver enlargement on one side and signs of some light fatty cells (as pre tx).

this wait for SVR has it's twists n turns seems so...

all the best