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Sudden Increase in ALT/AST after stopping Ntz and LIv 52 HB increases HbsAg
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
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
Chronic inflammation reduces the synthetic activity in the hepatocytes. Intense fibrosis is an independent reason for decreased functional capacity of the liver.
Therefore patients with hepatitis tend to have lower cholesterol levels.
This has to be seen however in consideration of the genetic background and other functional impairments like fatty liver and insulin resistance, which typically reduces HDL more than LDL cholesterol.
Therefore patients with hepatitis tend to have lower cholesterol levels.
This has to be seen however in consideration of the genetic background and other functional impairments like fatty liver and insulin resistance, which typically reduces HDL more than LDL cholesterol.
Hi,
Is there any relationship between lower cholesterol levels ( LDL , HDL) and Liver damage.
I have lower LDL and HDL which is below normal range -
LDL : 67 mg% (Normal Range :- 85-130)
HDL : 33mg% (Normal Range : 35-80);
Total Cholesterol : 132 mg% (Normal Range : 125 - 200)
Is there any relationship between lower cholesterol levels ( LDL , HDL) and Liver damage.
I have lower LDL and HDL which is below normal range -
LDL : 67 mg% (Normal Range :- 85-130)
HDL : 33mg% (Normal Range : 35-80);
Total Cholesterol : 132 mg% (Normal Range : 125 - 200)
The following information from www.hbvadovcate.org may convince your doctor not to prescribe Lamivudine.
Researchers Suggest Banning or Restricting Lamivudine to Avoid Drug Resistance
A global team of researchers suggest lamivudine (Epivir-HBV) never be used to treat hepatitis B patients because it frequently leads to drug resistance and sets the stage for resistance to other antivirals, such as entecavir (Baraclude).
Lamivudine, the first antiviral approved for hepatitis B treatment, has fallen out of favor in North America and Europe because of its high rate of drug resistance. But because of its low cost, it continues to be commonly used to treat hepatitis B virus (HBV) infection in Asia and Africa, where the majority of the world's hepatitis B patients live.
This report, published in the July 30 issue of PLoS One, examined the molecular make-up of the virus in many patients who had been treated with lamivudine as well as patients who had never been treated. They found the many untreated patients carry a mutation that allows HBV to quickly mutate and develop resistance to lamivudine.
"Our findings strongly suggest that the use of lamivudine will not benefit ...patients," they wrote because of the high risk of lamivudine resistance.
"Finally, since patients can quickly develop drug resistance to entecavir in the presence of lamivudine mutations, the lamivudine mutations can significantly compromise the efficacy of entecavir," they concluded.
They proposed that doctor screen patients for these mutations before ever prescribing lamivudine,"... to most effectively treat chronic hepatitis B patients by selecting only sensitive drugs."
An unrelated article published in the Annals of Medical and Health Sciences Research, also criticized the over-use of lamivudine in hepatitis B patients in Sub-Saharan Africa. Lamivudine was originally developed to treat HIV, but today African providers use it frequently to treat anyone with hepatitis B (when HIV is not present) because it is inexpensive and more effective hepatitis B antivirals, such as tenofovir (Viread) or entecavir, are more costly or unavailable.
But over-prescription of lamivudine for hepatitis B in this region has:
Increased drug resistance in African hepatitis B patients
Reduced availability of the antiviral to both HIV and HBV patients
And driven up the drug’s cost, which reduces its availability for more appropriate HIV treatment.
Critics say a bioethical dilemma has evolved, where doctors prescribe lamivudine to hepatitis B patients without explaining alternative treatment because they assume the patients don’t understand or are too poor to pay for more effective antivirals.
“Implied consent is no justification to embark on a particular treatment course,” researchers from Njala University in Sierra Leone wrote. “To tackle the growing problems of drug resistance and shortages with respect to lamivudine and other antivirals in HIV/AIDS treatment, health care resources should be prescribed with caution, irrespective of whether implied or explicit informed consent has been sought.”
Association of Preexisting Drug-Resistance Mutations and Treatment Failure in Hepatitis B Patients
Source: ww.ncbi.nlm.nih.gov/pmc/articles/PMC3728369/
Lurking Dangers Behind Overuse of Lamivudine to Treat Non-HIV Hepatitis B Patients in Africa
Source: ww.ncbi.nlm.nih.gov/pmc/articles/PMC3728885/
Researchers Suggest Banning or Restricting Lamivudine to Avoid Drug Resistance
A global team of researchers suggest lamivudine (Epivir-HBV) never be used to treat hepatitis B patients because it frequently leads to drug resistance and sets the stage for resistance to other antivirals, such as entecavir (Baraclude).
Lamivudine, the first antiviral approved for hepatitis B treatment, has fallen out of favor in North America and Europe because of its high rate of drug resistance. But because of its low cost, it continues to be commonly used to treat hepatitis B virus (HBV) infection in Asia and Africa, where the majority of the world's hepatitis B patients live.
This report, published in the July 30 issue of PLoS One, examined the molecular make-up of the virus in many patients who had been treated with lamivudine as well as patients who had never been treated. They found the many untreated patients carry a mutation that allows HBV to quickly mutate and develop resistance to lamivudine.
"Our findings strongly suggest that the use of lamivudine will not benefit ...patients," they wrote because of the high risk of lamivudine resistance.
"Finally, since patients can quickly develop drug resistance to entecavir in the presence of lamivudine mutations, the lamivudine mutations can significantly compromise the efficacy of entecavir," they concluded.
They proposed that doctor screen patients for these mutations before ever prescribing lamivudine,"... to most effectively treat chronic hepatitis B patients by selecting only sensitive drugs."
An unrelated article published in the Annals of Medical and Health Sciences Research, also criticized the over-use of lamivudine in hepatitis B patients in Sub-Saharan Africa. Lamivudine was originally developed to treat HIV, but today African providers use it frequently to treat anyone with hepatitis B (when HIV is not present) because it is inexpensive and more effective hepatitis B antivirals, such as tenofovir (Viread) or entecavir, are more costly or unavailable.
But over-prescription of lamivudine for hepatitis B in this region has:
Increased drug resistance in African hepatitis B patients
Reduced availability of the antiviral to both HIV and HBV patients
And driven up the drug’s cost, which reduces its availability for more appropriate HIV treatment.
Critics say a bioethical dilemma has evolved, where doctors prescribe lamivudine to hepatitis B patients without explaining alternative treatment because they assume the patients don’t understand or are too poor to pay for more effective antivirals.
“Implied consent is no justification to embark on a particular treatment course,” researchers from Njala University in Sierra Leone wrote. “To tackle the growing problems of drug resistance and shortages with respect to lamivudine and other antivirals in HIV/AIDS treatment, health care resources should be prescribed with caution, irrespective of whether implied or explicit informed consent has been sought.”
Association of Preexisting Drug-Resistance Mutations and Treatment Failure in Hepatitis B Patients
Source: ww.ncbi.nlm.nih.gov/pmc/articles/PMC3728369/
Lurking Dangers Behind Overuse of Lamivudine to Treat Non-HIV Hepatitis B Patients in Africa
Source: ww.ncbi.nlm.nih.gov/pmc/articles/PMC3728885/
Sure Stephen. I have booked appointment with Hepatologist today. My only concern is whether doctor will prescribe Tenofovir ? Doctors here are not very updated . They may start from lamivudine too.
Studyforhope has given you excellent advice and explanation. Treatment should be considered.
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