hbvdna alone has no meaning, you need hbsag quant in iu/ml, ast/alt and fibroscan to define hbv status
Hi my HBV DNA Quantative came positive and is 41,500 IU/mL it says HBV DNA Titter.
it was already known high alt, but not too high and for long time, has no correlation with liver damage.it is also well known that cirrhosis regression is also not correlated to alt, and infact my case has abnormal alt (if we take 30 as normal) and ultra fast regression of cirrohosis
but it was also known that low normal alt, epecially in asians, with high hbvdna can make liver damage
since all the results on heptech i tend to thin that oxidative stress made by immune system and hbv can make much more damage to the liver and activate proinflammatory macrophages and make liver damage with normal alt
we also know that liver damage is not directly correlated with dying of liver cells but to the fact that macrophages that repair liver at a certain point start to fail and inflammatory macrophages with stellate cells start the liver damage
I am just annoyed that they can come up with such a conclusion. It seems to me they base their analysis on a single reading of the patient's ALT at the time of biopsy, wouldn't it make sense to investigate whether persistent high level of ALT is associated with fibrosis?
May be they mean if you measure your ALT, if it is high, you cannot then say you have significant liver damage. But that is rather useless. I once read that when you have cirrhosis, your ALT will not be high because you have less healthy number of liver cells to be damaged.
levels of ALT are not associated with "significant" liver disease - I agree with you in interpretation "high ALT does not necessary mean high liver damage" how about normal ALT - it is this corelated with no liver disease ?
I can agree that high ALT does not necessary mean high liver damage in case of fibrosis, we can discuss high ALT from medicine, alcohol, food ...
they somehow relate the liver injury by AST and platelet.
AST ? ... hmm this is strange
Parts of the paper allured to this, yet it also states that levels of ALT are not associated with "significant" liver disease - that to me seems to say, high ALT does not necessary mean high liver damage. This is contrary to what we used to believe in. So what markers indicate liver injury?
I agree that this is a complex paper, but is a ppaper that made a warning that therapy (antiviral therapy) should be made using some other ALT thresholds.
This is a difficult paper to fully understand. What is the role of ALT in the management of chronic HepB?