Extent of liver damage

[JustLynn2U]

My boyfriend was diagnosed with HCV two years ago.  He underwent a year of co-pegasys treatment which was not successful.  He has an addiction to narcotic analgesics and Valium, and is prescribed Prozac.  He smokes cigarettes.  He does not drink alcohol.  Laboratory values in February 2004 (start of interferon) revealed AST 66, ALT 147, GGT 164, HBG 16.8, HCT 50.9, MCV 105.1, MCH 34.6, Platelets of 137, neutrophils 1452.  After one year of interferon and 1 1/2 years of narcotic addiction, lab evaluations are now: AST 234, ALT 107, GGT 75, MCH 33.4, other previously elevated/decreased values now normal.  His viral load recently was elevated at 4,400,000.  What I would like to know is what is the significance in the change in lab values and how much of this can be attributed to hepatotoxic medications/substances.  He was released from inpatient rehab and hopes to remain dependency free.  His second set of labs were done while in rehab and of note also revealed positive amphetamine (adderal), benzo. (valium), methadone, and opiates (oxy contin, percocet, duragesic).  His narcotics tolerance was very high and he was abusing large quantities of the above meds.  Is it possible to give a generalized prognosis on his liver condition based on this labs and whether any of it would be reversible with discontinuation of hepatotoxins and finally, how liver damaging is cigarette smoking of one pack of cigarettes per day?

[Kevin Pho, MD]

The fact that the liver function tests are increasing with a persistent elevation in the viral load is not encouraging.  

It is certainly possible that the quantities of the hepatotoxic medications may be playing a role in exacerbating the liver damage.  

Further evaluation, including a liver ultrasound as well as a liver biopsy, can be considered to document the extent of the liver damage.

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 patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[JustLynn2U]

In regard to his hepatitis with elevated liver function tests and viral load, assuming that he feels well, is it acceptable to resume cardiovascular and weight training exercises as he is a licensed sports trainer and previous body builder.