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Hep C Discussion Forum -> General Discussion -> Undetectable for over a year, but Liver Enzymes remain elevated
Post Info TOPIC: Undetectable for over a year, but Liver Enzymes remain elevated
Cinnamon Girl


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Undetectable for over a year, but Liver Enzymes remain elevated
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Hi Dre, welcome! 

I can understand your concern and I`m glad you`ve come here and shared your worries with us.  I think most of us continue to stress about every potential sign of relapse for a long time after our treatment, even after we`ve reached SVR, and that`s perfectly natural.

I must say I do agree with what the other members have already said and I don`t think you have any need to be concerned that these elevated liver enzyme levels indicate a relapse.  The most important factor here is that your viral load has been UND at 3, 6, and 9 months post EOT, and that really is the most reliable indicator that your treatment was successful and has remained so.  It would be very rare to relapse at this point, and in fact with the new DAA class of treatment drugs like Harvoni, it`s very rare to relapse after the 3 month UND point.  For some people it just takes a bit longer for everything to settle down after treatment, and in fact the healing process carries on for a lot longer than we realise. 

My advice would be to be guided by your doctor and try not to focus on thoughts of relapse..  smile

 

 

 



__________________

Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
Canuck


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Hi dtre,

You said .... "When I asked my doctor he said it can take a while to repair" ... 

Unfortunately, he may be right, and it will just take more time. Sigh.

On another thread, a while ago, didn't your doc indicate at one point, after a review of CAT/MRI, that you might be more cirrhotic than thought? So, maybe things take longer.

How are things going otherwise?? Is all good on the health front? How are you feeling, now that you have been SVR so long? smile C.

 

 

 



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
dtre30319


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Hello Pabilto,
  Im not a drinking or smoker.  The only thing I take is a probiotic, but doctor says that is fine to take.  



__________________

2002=Stage 0 (Gen 1A) 
2003=Peg/Inferon (Fail)
2012=Peg/Incivick (Fail)
2015=Harvoni (Undetectable)
Firbroscan 1
2017=undetectable (MRI liver regenerating)
September 2018 = Still undectable

 

 
Pablito


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Nothing to worry about IMO.   Your LFTs show a general and substantial downward trend since treatment.  They are only slightly above the reference range currently.  A reference range is just that: an average range that most people's results fall in.  Being slightly above that range is essentially normal and I bet the next tests will show regression to the mean and be in the normal range.

But as Jimmy points out run it by your doctor.  LFTs can be affected by loads of things...alcohol and medications being two of the most common.  Are you on any meds and are you drinking?

Pablo



__________________

44 y.o. male, HCV G4 since 1996, F-scan score 9, F2, Failed prior I/R, finished sof/vel/vox 8 weeks 5/16, pre-treatment VL 2 million, EOT UND, EOT+4 UND, EOT+12 UND.
JimmyK


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Hello again.

Interesting to say the least.

Start of treatment with Harvoni I will assume readings of AP 232, ALT 74 and AST 187.

It looks like you then did a reading at roughly two weeks into treatment and the AP dropped significantly to 136, ALT down to 46 and AST down to 126.

Then it looks like EOT + 12 AP and ALT in normal range and AST slightly elevated.

Then a slight steady progression through march of this year but come July all three were normal.

Now as of today you are back to being slightly elevated.

This assumes I am reading the data properly.

So I would first of all note that variances are normal and do happen. Can be based on a number of factors. So I would temd to want to compare SOT to today.

 

08:29:00 AM

Alkaline Phosphatase

232

[38 - 126 U/L]

Comprehensive Metabolic Panel

 

08:29:00 AM

ALT (SGPT)

74

[21 - 72 U/L]

Comprehensive Metabolic Panel

 

08:29:00 AM

AST (SGOT)

187

[17 - 59 U/L]

Comprehensive Metabolic Panel

 

That would be starting point. Now for present reading..

09:03:00 AM

Alkaline Phosphatase

104

[38 - 126 U/L]

Comprehensive Metabolic Panel

09:03:00 AM

ALT (SGPT)

86

[21 - 72 U/L]

Comprehensive Metabolic Panel

09:03:00 AM

AST (SGOT)

67

[17 - 59 U/L]

Comprehensive Metabolic Panel

Ok the AST findings, to me are significant. AST can be used to determine Liver Damage or indications thereof.

You went from 187 at SOT to present day 67. That is a huge improvement!

ALT has gone up yes. From July to October 47 then 86. The 86 is slightly out of range but again, there are many things that can cause fluctuation.

The ALP however is in the normal range and has shown a significant drop since SOT. In fact it has shown a healthy drop just since March of this year.

As always, we would advise that you consult your physician with your concerns, questions and requests for further evaluation. If I were to see the same spread of variance I too would question things but at this point I would not lose sleep over it.

The mending time in your case is less than one year and it is a normal process in particular with someone who has treated 3 times in 12 years.

The UND is very important. That allows for a healing to begin but the key word is "begin". Takes some time my friend.

Hang in there!

 

JimmyK



__________________

Harvoni TX 2 12 weeks. UND weeks 4, 12 and now EOT + 4 Weeks. SVR-12 09/29/16. All Glory, Honor and Thanks be to God.

"I go to war with the brothers I trust."
dtre30319


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Hello Jimmy,
  Attached, you will find all labs.



Attachments
Liver_Enzymes.docx (127.9 kb)
__________________

2002=Stage 0 (Gen 1A) 
2003=Peg/Inferon (Fail)
2012=Peg/Incivick (Fail)
2015=Harvoni (Undetectable)
Firbroscan 1
2017=undetectable (MRI liver regenerating)
September 2018 = Still undectable

 

 
JimmyK


Guru

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Greetings and Congrats on the SVR!

Can you expound some please?

What are your current ALT and AST readinmgs?

 

Thanks!

 

JimmyK



__________________

Harvoni TX 2 12 weeks. UND weeks 4, 12 and now EOT + 4 Weeks. SVR-12 09/29/16. All Glory, Honor and Thanks be to God.

"I go to war with the brothers I trust."
dtre30319


Member

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Posts: 21
Date:
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Hello Everyone,
  I ended Harvoni on September 28, 2015 and complete treatment successfully.  I have had 3,6, and 9-month blood test and all have come back hepc negative.  However, from reading the forms, my liver enzymes should have come down during treatment and remained.  When I asked my doctor he said it can take a while to repair.  My fibrosis scan was 0-2.  Has anyone else liver enzymes not gone down a year after treatment?



__________________

2002=Stage 0 (Gen 1A) 
2003=Peg/Inferon (Fail)
2012=Peg/Incivick (Fail)
2015=Harvoni (Undetectable)
Firbroscan 1
2017=undetectable (MRI liver regenerating)
September 2018 = Still undectable

 

 
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