High AST, ALT, FERRITIN, IRON Levels

I have chronic HCV geneotype 3A, and am a carrier of Hemochromatosis (HH) single mutation C282Y.  I just finished up 46 weeks of Pegasys and Ribavirin, however, my concern is that although my liver enzymes did come down, they are still elevated, AST--82 (7-45),  ALT--114 (1-45),  and ferritin is around 1100, iron is also very high.  My questions are as follows:

If I cleared the virus (so far), shouldn't my AST, ALT levels have leveled off into the norm?  I'm under the impression that when the virus is undetectable, these enzyme levels should be back to normal because the virus is no longer present--causing inflammation???

If I'm am only a carrier of HH, why are my ferritin and iron levels very high?

When a liver BX is performed, is it protocol to automatically check for fatty liver (NASH) and/or the mitochondrial?  If so, what terminology (the wording) would be used for fatty liver--to convey this on the biopsy report, as well as on a CT SCAN, Ultrasound?

Will fatty liver be picked up by CT SCAN, Ultrasound?

Lastly, my Lymphocytes are high, 61.6  (20-44).  What does this mean?  Liver inflammation?  Non-Liver inflammation?

Many thanks, Doc!!!

[Kevin Pho, MD]

Assuming the viral levels are undetectable, you may want to look for other causes of elevated liver enzymes.

Yes, a liver biopsy would be able to detect NASH and fatty liver.  Imaging studies also can suggest the disease, but the biopsy is definitive.

Repeating the imaging studies can be considered.

Elevated lymphocytes can be due to any number of viral infections, including hepatitis.  By itself, it cannot be indicative of liver inflammation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[Bryant7]

I am homozygous for the c2 gene for Hemochromatosis . My ferritin was only 580 at Dx. I would start giving blood at least every week until the ferritin came down below 20 .I wouldnt be worried about an invasive & risky liver biopsy that is only going to delay treatment because the ferritin needs to come down regardless.Google iron overload.org & contact their spokes person.

[fish22]

Thank you, Doc, and Bryant7 for all your help...

P.S. Bryant7, I did check out that website. wow!!  A  great source of info I wasn't aware of.  This opens up other doors for me to consider--given my problems.  Thanks again for that hook-up and, good lookin' out!!!

[lanesra13]

A related discussion, What is the normal reading for ALT was started.