Elevated ALT (100-140) for a year! Need urgent help

[mrgold]

Dear all,
I was one of unluckies who got hbv in 2007. I did not have any systematic treatment (6 month lvmd in 2009), in 2010 peg-int for 6 months, until 2011. In 2011 i started taking nucs telbivudine. My hbsag kept to be very low around 2000ml, hbvdna not detectable since 2010, alt/ast normal.

However my alt jumped in august 2013, to 120 and it is not falling back since then.(ast-70). Liver protecting drugs are not helping.

In february 2014, because of elevated heart proteins (kreatinin kinease) (side effect of Telbivudine), we decided to switch nucs to entecavir. Following all instructions with switching period.

With entecavir my hbsag elevated dramatically 23000ml. Even though my hbvdna is still not detectable, my alt is still elevated around 100-140.

My hepatology doctor  is insisting that i have fat liver, may there be any other reasons? Maybe i should stop taking nucs?

(She is also insisting on liver puncture, but i am resisting it)

I am male 28, 85kg 180cm (i have fat belly)
I am hbeAg negative

[mrgold]

We do not have fibro scan, do you think liver puncture is important?

[SafiSifa]

Hello,

I think your doctor's insisting is true.Because your HBV DNA is still undetectable.

The other alternative is that your HBEAG turned from negative to positive.

The only way to learn what is happening, you should do these tests;

1. FIBROSCAN (very important)
2. HBSAG (in quantity)
3. HBEAG
4. ANTI-HBS
5. ANTI-HBE
6. HBVDNA
7. ALT
8. AST
9. AFP
10. CREATININ
11. URINE
12. VIT D LEVEL
13. SEDIMENTATION