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hepatitis b SGPT SGOT are rising
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hepatitis b SGPT SGOT are rising

date: 07/07/2012:my SGOT=109IU/L SGPT=292 IU/L
date :29-may-2013:my SGOT =233 IU /L ,SGPT=504 IU/L
can any one explain SGPT ,SGOT Levels?
why these values are  rising ?
what is the  dager level of SGPT  & SGOT ?
32 Comments Post a Comment
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Avatar_m_tn
The numbers are rising because more liver cells are destroyed. The reasons could be different. Tell more about your condition, areyou hbver? Post your orher tests.
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5971510_tn?1377968893
can u please tell me wat is "orher tests"?
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5971510_tn?1377968893
what is "hbver" ? i dont get this term?
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5971510_tn?1377968893
yes i've a hepetits b since 2012.
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5971510_tn?1377968893
im a indian male aged 25 .
this is my blood report of 7/7/2012

total bilirubin :0.58mg/dl
direct  bilirubin : 0.29mg/dl
Indirect  bilirubin: 0.29mg/dl

SGOT 109.0 IU /L
SGPT :292.0 IU /L
ALK.pjosphatase :105.o IU /L
Total proteins 7.1 gms/ DL
s.Alnumin :3.7gms /dl
s.globulin :3.4 gms /DL
A/G Ratio : 1.1 : 1
prothrombin time :16 secs
INR:1.0
HBsAG :postivie


DATE:29-may-13(recent)

total bilirubin : 0.8mg/dl
direct  bilirubin : 0.4mg/dl
Indirect  bilirubin : 0.4mg/dl

SGOT :233.0 IU /L
SGPT :504.0 IU /L
ALK.phosphatase :74 IU /L
Total proteins : 6 gms / DL
s.Alnumin :3.6gms /dl
s.globulin :3.4 gms /DL
A/G Ratio : 1 : 0
prothrombin time :24 secs
INR:1.5
HBsAG :postivie

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Avatar_m_tn
do the tests:  dna quatative, hbsag quantative with dilution and hbeag qualitative and vit d. then only memebers can help you positively. and what medicine u take and going to start.
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Avatar_m_tn
most probably you are in clearance phase so sgpt is increasing but not sure. can say anything after few months. do the above tests including sgpt and cbc, monthly or bimonthly and dna quantative after each 4 month to monitor.
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5971510_tn?1377968893
i've took  many test as suggested by doctor here are the details
date: 2013-05-08

Molecular Biology

Hepatitis b viral load
method :real time PCR
resukt(iu/ml) >10000 0000(8 zeros)
result(copies /ml)>70000 0000(8 zeros)

immunology /serology

hepetitis (hepatitis) b envelope antibody(antiBHe) --5.46 --units[S/co]-method:ELISA
hepetitis (hepatitis) b envelope antigen(HBeAg)--7.01-units[s/co] -method:ELSIA
hepetitis (hepatitis) b surface antigen(HBsAG)-10.28-units[s/co]--method:Elisa


Clinical biochemistry

alpha Feto Protein (AFP)-serum --results 5.2--units IU/ml
method :chemiluminescenece
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Avatar_m_tn
With such viral load no wonder alt is high, do you take any medicine?

You should take antivirals Tenofovir is the best so far.

Also you need to do fibroscan and ultrasound. And you need a doctor who knows about hbv, not just GP or GI.
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Avatar_m_tn
hbsag quantative is not in iu/ml and useless without units.
high viral load is common in young age due to immune tolerance so dont worry and dont hurry...remember strictly...dont hurry.. check vit d level and report us. steff is studying vit d effect on hvb.so please report here.

this may be not right time for antiviral treatment as you are entering in/entered in immune clearnace phase plus your age is less, so if possible wait and see for a year. if you strictly want to start treatment go for interferon, in india local brands at 5000 rupee/shot are available. it may be good as alt is high. try it for 3 months and see. while on interferon go for hbsag quantative test with dilution  in iu/ml units before starting interferon and then after each month.. may be available in india under some dr. lal pathlabs..talk their customer care.
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5971510_tn?1377968893
the doctors also took the ultrasonography abdomen
date:4-02-2012

Liver :Normal in size and echo pattern.No evidence of any focal lesions,No evidence of IHBD

gall bladder:Distended.No evidence of any calculi.No  evidence of wall thickening . NO evidence of peri cholecystic fluid collections

CBD: Not dilated(measuring 5mm .arppr.)
portal vein : Normal in calibre( measuring 8mm .arppr)
pancreas : Normal in size echo pattern.pancreatic duct not dilated.No evidence of any peri pancreatic edema/collections

spleen : noral in size and echo pattern(measuring 11mm .arppr)

kidneys: normal in size .cortical echogenecity normal.Cortico medullary differentiation is maintained.No evidence of any calculi.No evidence of hydronephrosis.No evidence of  cysts.
             RK:9.6x4.7 cm .LK :9.3x 4.5 cm.

Urinary bladder :distended.No evidence of any calculi.No evidence of wall thickening.
prostate : Normal in size
*IVC & Aorta-normal
*No evidence of  free fluid in the abdomen/pleural effusion.
*No evidence of lymphadenopathy.

IMPRESSION : Essentially normal Study .
      
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5971510_tn?1377968893
my doctor suggests me to take a pegasys (exxura) of Hoffmann-La Roche
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Avatar_m_tn
yes, go for pegasys.
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Avatar_m_tn
Do not start any treatment until you get normal hbsag quantity test. The one that you have is useless. You need to find abbott architect in IU/ml.

With such high viral load you hbsag could be high and interferon works well only when hbsag < 1000.

You may need to take tenofovor for a few years before starting intf.
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Avatar_m_tn
though viral load is high, but it is common in immune clearace phase. your alt is high, so interferon may work well for you. there is no general rule for starting interferon except high alt all other parameters are very much dependent on individual immune system working.

your age is only 25, so personal suggestion for now, donot start antiviral at any cost atleast for next 5 years.
as new things for better treatment are on the way 2017.

rome70 is correct do hbsag quantative with dilution in iu/ml before interferon. and your doctor is right go for pagasys before your alt will come down. you must decide early to get most benefitted.
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Avatar_m_tn
Intf along works more or less well only on hbe pos, for hbe neg independant of the alt hbs clearence rate is less than 10%
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Avatar_m_tn
perhaps sleepyeinstien is hbeag+.

if you go by hbsag<1000 for hbeag+ , then perhaps nearly no hbeag+ would be recommented for interferon as hbsag is generally very high in hbeag people.

best thing is try and see, even if there are slight chances, better give 1-2 month trial and see results than only hoping.
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Avatar_m_tn
I  presumed  hbe neg.

Intf response is checked on the 12th week not in 1 month.

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Avatar_m_tn
interferron response can be predicted with better confidence level if used for longer duration.(not guaranteed but with good chances)
best prediction needs 24 weeks.
better prediction needs 12 weeks
good prediction needs 4-6 weeks

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5971510_tn?1377968893
how much it cost "hbsag quantative with dilution" in india. ??  i asked dr.lalpathlabs  in our town (vijayawada,andhra pradesh,india)..they said 1200 rupee.problem  is the person (girl) who attend my call hesitated to give the answer about dilution ? she callback to me after 15 min ..said yes we will do hbsag quantative with dilution ...so can i trust them ?  
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5971510_tn?1377968893
how much it cost "hbsag quantative with dilution" in india. ??  i asked dr.lalpathlabs  in our town (vijayawada,andhra pradesh)..they said 1200 rupee.problem  is the person (girl) who attend my call hesitated to give the answer about dilution ? she callback to me after 15 min ..said yes we will do hbsag quantative with dilution ...so can i trust them ?  
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Avatar_m_tn
Interferon mono therapy has a high failure rate with that HIGH viral load.
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Avatar_m_tn
Sorry mate I have no idea about india. The lab should have also automatic dilution not manual, manual dilution is not exact.
Are you hbe neg? (Hbeag reactive?)
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Avatar_m_tn
There are some good labs in india, some peo
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Avatar_m_tn
There are some good labs in india, some people even send blood there from other countries. Search the forum amd you should find the address.
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Avatar_m_tn
yes it is with dilution. trust them they are good.
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5971510_tn?1377968893
date:30-aug-2013

test:LFT


total bilirubin : 0.47mg/dl(method:jendrassi-grof)


direct  bilirubin : 0.16mg/dl(method:diazonium salt)

Indirect  bilirubin: 0.31 mg/dl(method:calculatd)

SGOT(AST)  : 32 IU /L(method:henry's)

SGPT (ALT) :65.0 IU /L(method:henry's)

ALKaline.phosphatase :60.o IU /L(method:kinetic with AMP buffer)


Gamma Glutamyl transferase :26 U/L(method:szasz)


Total proteins : 7.6 gms/ DL(method:biuret)

Albumin :4.2gms /dl(method:bromcresol purple)

globulin : 3.4 gms /DL(method:caluculatd)

Albumin/Globulin Ratio : 1.2
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Avatar_m_tn
My situation is as follows

hbsag + since 2005
anti hbs -
hbeag -
anti hbe +
alt and ast normal
hbv dna less than 116 copies / ml ( undetectable )

HBsAg quantitaive from 19 to 13.4 then 16 and now 20.23 over last one year in iu/ml
No treatment taken

Now have started with
-PEG interferon 180 mcg once weekly
-Alinia 2gm daily in divided doses
-Vit D
-Simvastatin 20 mg daily

What do u say
can i become HBsAg negative with this treatment
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Avatar_m_tn
I think  that with such low hbsag  you have a lot of chances.
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Avatar_m_tn
is it the right strategy
i have waited quite some years for it to clear but now i am desperate
I literally forced my dr to start this treatment
am i making any mistake
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Avatar_m_tn
is it the right strategy
i have waited quite some years for it to clear but now i am desperate
I literally forced my dr to start this treatment
am i making any mistake
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Avatar_m_tn
Nobody knows...

Check your hbs ag monthly, if week 12 shows decrease then you are responding.

http://www.ncbi.nlm.nih.gov/pubmed/19115222
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