ALT/AST results

[MelvynB]

I am in week 8 of triple (Victrelis). Going for 8 week viral load test tomorrow. My 4 week was a 2.5 log drop for 4.8M to 26,000. i just got my last bloodwork results and my Hgb is at 10.8 (down from 14.5 pre tx) but my AST/ALT were 22 and 50 respectively. The AST is midrange normal and the ALT is slightly over the 17-48 normal range. Not sure what to read into this other than it appears my liver is not under any stress and seems to be dealing with the meds pretty well. Anyone have any thoughts, experience with these readings?

[sandysf]

Just to put your mind at rest, when I started Victrelis my ALT/AST jumped significantly then balanced back out, within a few weeks my ALT was at 12!!  So don't worry, as Hector said, focus on VL and good luck.

[MelvynB]

Thanks Hector. Trust me, I am very focused on the 8 week which I will get tomorrow. I will be on pins and needles waiting for the result.

[HectorSF]

I would think you would be focusing on your critical 8-week viral load test results. You had a very good viral load drop just from interferon and ribavirin by week 4. That drop is a good indicator of treatment success. The sooner your viral load is undetectable the better chance of SVR.

Week 8 is the most critical week for people that treat with Victrelis. (Besides weeks 12 & 24 "treatment futility rules" when treatment should be stopped) The week-8 viral load helps to predict your chances of SVR and the duration of treatment. 28-weeks if undetectable vs 48-weeks if detectable. If you are undetectable at week 8 (early responder) you have about an 88% chance of SVR and need only to treat for 28 weeks. If you are not undetectable, your chances of SVR drop and you will need to treat for 48 weeks to have the best odds of SVR.
"Among subjects with detectable HCV-RNA at TW8 who had attained undetectable HCV-RNA at TW24 and completed at least 28 weeks of treatment, the SVR rates were 66% (45/68) in VICTRELIS-RGT arm (4 weeks of PegIntron and REBETOL then 24 weeks of VICTRELIS with PegIntron and REBETOL followed by 20 weeks of PegIntron and REBETOL alone) and 75% (55/73) in VICTRELIS-PR48 arms (4 weeks of PegIntron and REBETOL then 44 weeks of VICTRELIS with PegIntron and REBETOL)."

AST/ALT has no affect on treatment success nor does it indicate a possible problematic major treatment side effect such as anemia which is HGB < 10.

Good luck with being UND!
Hector