Hep b levels & ranges

[Mrr49]

I have written on this forum again in the last few days about my status & alt level. Although guidelines say up to 30 (my last level 33) done by a different lab to my usual one as it was done by my doc not my hepatologist.
People on this site go by guideline levels, but on reading up on alt levels they can be 10-20 times higher as abnormal. Plus ranges vary anything up to 56. Very confusing.
Also my last afp was 1.1 but was is the range on that? Any advice please

[Aduiski]

Post as much as detailed current and past results in the single topic where you want to get advice. ALT alone is not enough to estimate your condition. I don't think many people will put an effort of going trough your past post to gather all of your previous results.

[nicolefor]

As far as your dna is negatif and you don't drink alcohol , your diet can cause sudden movements of alat and asat , or other health problems . Morever , the increase level is not high that way , it's with HCV virus that an increase with just 1 with alat above the normal range creats fear. And your fibroscan is in normal range though constantly pushing up . just eat well ,they will all run down

[Mrr49]

Thanks aduiski for answering. I have left a few more questions addressed to you so I thank you in advance for your patience.
I must say I have been so stressed over hcc fear for 18 months & wonder if that has lowered my immune system.
I eat really well so hope I can reduce levels.

[Mrr49]

Tests done same place. I saw doc yesterday & he said my dna would be fine. He is doing annual tests only, due September. He said if it has risen between now & then he would review starting tenofovir to bring dna back down & it would not have started fibrosis.
Do you know anywhere in UK I can get tested. Even my gp will not do tests as she has spoken to doc & it does not warrant it. I thought that was good news but now I am terrified again. I live in south east England. Docs range 10-50 on alt so 33 is ok I thought.

[Aduiski]

If you did your Fibroscan at the very same place then there is probably correlation between your rising fibroscan and rising ALT, but if you did Fibroscan at different places the raise in fibroscan values might also be more a random variation between different machines and operators then a steady patter of raise.

As your ALT and Fibroscan were rising recently...especially your ALT (even though it is still only not too high...well just above the 30)...on your place I would now take measure now the DNA again (even if you have to pay yourself) to see whether it was risen.
It might be that your ALT raise of 33 is due to same other reason non-related to hepatitis, or it might be that it is because your hepatitis has increased. If you measure your DNA that might give you the answer to that.

Because of increased values of fibroscan and ALT I would recommend to measure ALT and DNA just a bit more frequently in the future, just so that you stay on top of the situation, but I wouldn't stress to much about it.

[Aduiski]

Were you doing all of your fibroscan tests at the same place or at different places?

[Mrr49]

Thanks Aduiski for your time & help.
God bless.

[Mrr49]

Aduiski
Don't know if relevant but the highest my dna has been since diagnosed 22+ yrs ago was 500.
I think that is why doc is saying it's good place to be looking at all my results over time.

[Mrr49]

31 Dec 2013 fibroscan 4.4, alt 18, dna 150iu/ml. afp 1.4
10 Feb 2014 no fibroscan, alt 16, dna not detected, no afp
17 Nov 2014 fibroscan 4.9, alt 17, dna 10 iu/ml, afp 1.2
15 Sep 2015 fibroscan 5.3, alt 23, dna not detected, afp 1.1
22 Jan 2016 only alt 33.

[Aduiski]

Maybe you can look for a good hepatologist that has a private practice, but it all depends on the system in your country. You can get a referral from a different doc.

Truly inactive carriers usually have hbsag bellow 1000.

Can you post the dates (together with values) of your ALT measurements and Fibroscan measurements in the past 1-2 years, to see if there is a patter of both of them increasing in parallel?

Post also the dates and values of all of the measurements of all of your DNA that you did in the past 2 years.

On your place I would do 6-monthly ultrasounds (maybe also together with AFP tests).

[Mrr49]

Sorry Aduiski
Dna und. Afp 1.1. Alt 33 was 23.Bilirubin 14 was 6. Alk phos.57. Globulin 23.
Albumin 43. Total protein 66. Fibroscan 4.4, then 4.9, then last one 5.3kpa. Creatinine 68. Platelet count 252.0. (E.ant-, anti be+. I have been in this level since diagnosis.) Ultrasound normal. 66yrs old. Diagnosed 22yrs ago, but had it probably 25yrs or so before. Hbsag 5000.Inactive not true inactive but they said minimal risk of development in both groups due to my long stable history.
Mcvu level 90.5 what that means?
I asked for an/ ultrasound 6 monthly & he said annual sufficient. Not too happy but he insists.
Do you think I should get a second opinion but I have tried through my doc & my hepatologist & they will not refer me. Any ideas how I can go about this without a referral.