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ALT and AST keeps elevated
Hi,
This is my first post here. I am 32 years old male, living in the United States and I have HBV since birth. Two weeks ago, I started using tenofovir (viread), but my ALT and AST levels are remarkably increasing in the past two months. I wonder if anyone has any explanation for this?

My test results are below and I will keep them updated as I have more test results.

Anti-HBS: negative
Anti HBE: positive
HBS AG: Positive
HBE ANTIGEN: Negative
HBe Antibody: Positive
HBcAb Total: Positive
ANTI-HAV TOTAL: Positive

February 7, 2014
HBV DNA, QN, PCR: 19837 IU/mL
ALT: 46 IU/L
AST: 22 IU/L

May 2, 2014
HBV DNA, QN, PCR: 24047 IU/mL
ALT: 61 IU/L

August 27, 2014
HBV DNA, QN, PCR: 103000 IU/mL
ALT: 78 IU/L

February 5, 2015
HBV DNA, QN, PCR: 5533153 IU/mL
ALT: 238 IU/L
AST: 74 IU/L
Vitamin D, 25-OH, D3: 19 ng/mL
Started using vitamin D-5000 iu

March 4, 2015
ALT: 699 IU/L
AST: 217 IU/L
Vitamin D 25-OH, D3: 43 ng/mL


March 5, 2015: Started using tenofovir (Viread) 300mg


March 18, 2015
ALT: 1340 IU/L
AST: 488 IU/L

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13 Answers
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Avatar universal
I am not a doctor. Some points for you to consider:
1. your ALT was rising together with your viral load before treatment;
2. you had only started treatment two weeks ago, so is it too early for Viread to reverse the trend? You may like to ask your doctor.
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Interesting that your viral load went crazy up suddenly after all these years
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Thank you for the quick reply. Yes, I know it is still very early for the Viread effect, but I am just worried of these sudden increases at ALT and AST.
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Yes, unfortunately, I was okay for a good time. Then, since the beginning of 2014 my HBV DNA, ALT, AST started increasing. I hope viread will be able to decrease these numbers (fingers crossed).  
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Check your hbeag just to make sure it is still negative
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HBeAg was checked on February 9, 2015, and still negative.
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Usually it will take viread up to 6 months to make hbv dna undetectable. Where you originally from this way we will know your gebotype
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I am originally from Turkey, but I don't know my genotype.
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Ok so you most likely have genotype D just like me since we both from mediterrenean
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Good news, viread worked.
My ALT level is now 20 U/L and AST is 21 U/L.

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What about the virus load? Has it reduce as well?
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The current HBV DNA is 38 IU/ml
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useless question of course antivirals make viral load undetectable
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Thanks Stef, My current HBsAG value is 4041 and I wonder what does this value indicate (if anything specific)? Is there a certain threshold for this value?
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it just indicates it is too high to clear hbsag by peg or nucs

this said the use of nucs for 5-10years, vit d3, healthy life, immune modulators like gcmaf may lower hbsag.my experience is that when i started nucs hbsag was 5000-7000iu/ml and today by use of nucs, vitamins, gcmaf and peginterferon is 800-1200iu/ml

i guess my hbsg will go very low at 10 years of nucs if i reached such decline by 5 years, also most of the decline by nucs is between 5 to 10 years
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