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Sudden Increase in ALT/AST after stopping Ntz and LIv 52 HB increases HbsAg
Avatar_m_tn
by smile_boy, Mar 01, 2012
Hi Stef and Others,

There is a sudden increase in my AST and ALT values after stopping Ntz. I stopped Ntz in August 2011 end and later I started taking Liv52 HB.

Results on Feb-2012:-
ASPARTATE AMINOTRANSFERASE (SGOT )PHOTOMETRY =98.00 U/l M: 0 to 37 - F: 0 to 31
ALANINE TRANSAMINASE (SGPT) PHOTOMETRY = 244.00 U/l M: 0 to 37 - F: 0 to 31

ALKALINE PHOSPHATASE PHOTOMETRY =98.30 U/l M:53 to 128 - F:42 to 98
BILIRUBIN -DIRECT PHOTOMETRY =0.26 mg/dl 0 - 0.3
BILIRUBIN - TOTAL PHOTOMETRY= 0.85 mg/dl 0 - 1.2
BILIRUBIN (INDIRECT) CALCULATED =0.59 mg/dl 0 - 0.9
GAMMA GLUTAMYL TRANSFERASE (GGT)PHOTOMETRY =21.00 U/l M: 0 to 50 - F :0 to 30
PROTEIN - TOTAL PHOTOMETRY =8.30 gm/dl 6.0 - 8.3
ALBUMIN - SERUM PHOTOMETRY= 4.56 gm/dl 3.2 - 5.0
SERUM ALBUMIN/GLOBULIN RATIO CALCULATED =1.22 Ratio 0.9 - 2.0
25-OH VITAMIN D TOTAL= 37.26 ng/ml
HbsAg Quant - 1789 iu/ml



Results on Aug -2011:-
SGOT - 25.90
SGPT - 38.90
HbsAG - 733 iu/ml

Almost SGPT has increased 10 times. Kindly help me. I'm very scared about my situation. If stopping ntz increases ALT ans AST ,we cannot take ntz for life long? please help

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Member Comments (125)
Avatar_m_tn
by stef2011, Mar 01, 2012

stoppingntz doesn not change your situation but i think liv52 did because hbsag has increased frominactive carrier to cronic hbv

anyway having alt 200 is not bad at all if hbvdna is extremely low or undetactable because it means your immune system see the virus and is fighting, if you find also hbvdna high that would be a big problem

get back to ntz+vitd3 (37 is too low, get it to 80ng/ml)

then check hbvdna too, if hbvdna is low i d go for ntz lead in for 12 weeks and then addon generic interferon+simvastatin+vit d3 to clear hbv
Avatar_m_tn
by stef2011, Mar 01, 2012

in case hbvdna is high we have to use tenofovir or see if alinia is able to lower it monotherapy

Avatar_m_tn
by 4est, Mar 01, 2012
do you have also some other (previous) test results ?

I can agree with you that it seams that stooping NTZ couses ATL/AST flare but I wandering if this is the case (should be something else and to be only a coincidence)

how was your qHbsAg before styrting NTZ ? (NTZ decrese this value ?)

how about your HBV DNA - is this increasing / decreasing also ?

(NTZ = alinia ? )
Avatar_m_tn
by stef2011, Mar 01, 2012

checking all your tests:

creatinine is a bit high, nothing to worry and easy to correct, do you make gym/bodybuilding, hbv can also attak kidneys

hdl is very low, this is bad because hdl has also antiviral effect.glutathione by injections or liposomal+vit d3>50ng/ml, fish oil omega3 or fish diet, can increase to 65-70 easily

alt 255 is a good flare after we know hbvdna we can understand immune status by comparing hbsag and hbvdna and kinetics

Avatar_m_tn
by smile_boy, Mar 01, 2012
I didn't check qHbsAg before taking Alinia (Nizonide-Ntz) . After 2 months of taking Ntz it came to 1000iu/ml and after 4 months it even came to 500 iu/ml.

But after that it gradually increased to 730 iu/ml (with Ntz) . So I stopped Ntz and later I started with Liv 52 HB,
After that my qHbsAg has increased t0 1789 iu/ml

My HBV DNA was 9000 Copies/ml  on Decemeber-2011. After that I have not checked DNA Values.
Avatar_m_tn
by smile_boy, Mar 01, 2012
Stef,

I don't go for gym or any body building exercises. I have normal physique (178 cm/82 Kg) .

Avatar_m_tn
by smile_boy, Mar 01, 2012
I didn't check qHbsAg before taking Alinia (Nizonide-Ntz) . After 2 months of taking Ntz it came to 1000iu/ml and after 4 months it even came to 500 iu/ml.

But after that it gradually increased to 730 iu/ml (with Ntz) . So I stopped Ntz and later I started with Liv 52 HB,
After that my qHbsAg has increased t0 1789 iu/ml

My HBV DNA was 9000 Copies/ml  on Decemeber-2010 (sorry not on dec2011) . After that I have not checked DNA Values.
Avatar_m_tn
by stef2011, Mar 01, 2012

creatinine is a very poor test for kidnesys because big muscles can make creatinine even 1.4 not correlated with kidneys.if you want to be on the safest side take a 24hrs urine test of creatinine clearance that will confirm kidneys function.i stress again this is to be ultra safe side and to prevent in any case.

kidneys function can be improved by making hbvdna und, by fibroguard, by antioxidants like vit d and gluta injection or liposomal

anyway youare still close to hbsag 1500iu/ml which has highest chances to clear hbv, according to the hbvdna level we may think an off label combo like this:
alinia-tenofovir lead in 24 weeks and then recheck hbsag/hbvdna if low

alinia-tenofovir-interferon or peginterferon-simvastatin-vitd3, i am sure you ll clear fast like it happened to otan on such a combo
Avatar_m_tn
by stef2011, Mar 01, 2012

since we dont know your baseline hbsag and hbvdna there is another way to think about what happened.

your baseline could have been hbsag 1700iu/ml and hbvdna 9000iu/ml, alinia lowered them and when you stop they just got back to baseline values

the difference can be your immune system is now stronger and made a alt flare trying to clear the infected cells, it is better to act while we have the alt flare and i think alinia is the best to retry now and then add interferon