AST/ALT have been going up steadily 129/144

Hello,
I have had Hepatits C for either for 47 or 24 years depending on how I contracted it. dx in 1999 (after having the "flu" for over 3 months. I had  my last (of 2) biopsy in 2002 which showed Stage 2/4 Grade 2/4. I have never done tx. I lead a healthy lifestyle, feel great and have not had so much as a cold in 2 years. Now my AST/ALT have been going up steadily...65/82 in 4/2009 to 102/111 in 4/2010 to 129/144 in 8/2010 (just 4 months). Is AST 129 ALT 144 very high for a CHCV patient?  Should I have another Biopsy? Should I be alarmed?

[Boobert]

That's definitely on the high side but also common. It's been 8 years since your last Biopsy so your past due. Doctors recommend biopsies between 3 & 5 years, as far as being alarmed there's no use for that. Have a biopsy done your due.

[portann]

Agree with Boobert that it's time for a biopsy, based on the 3-5 year recommendation. And that's even if your LFT's had remained stable.

That healthy lifestyle throws me off a bit because it's sure not alcohol contributing to the spike. Sometimes it's exercise but don't know too much about that.

Try checking out all the possible causes of elevated LFT's (on wrong diagnosis, for example) and see if anything in your current lifestyle or profile corresponds.

Anyway, waiting and living with HCV entails watching and you need to do that just as much as living 'healthy'. See if you can get yourself in for an appointment with a hepatologist, preferably at a teaching hospital and take it from there.

Time flies, I know but it seems to me your biopsy is long overdue, kid.

Susan

[DragonHater]

Newer blood tests are being proved to be just as good and cheaper than a liver biopsy, I did both and they were the same.

It's called   Metavir Fibrosis scoring scale, the bloodwork  takes 2 weeks to get back.

[Bill1954]

I think the tests Dragonhater might be referring to are the ‘Fibrospect’ and ‘Fibrosure’ blood tests? Unfortunately, these test results don’t always correspond with pathology reports, and are more accurate towards the ends of the scale than they are in the middle; i.e. they are fairly specific for demonstrating cirrhosis, but don’t differentiate well between stage 2 and stage 3 fibrosis.

--Bill

[nygirl7]

In 8 years you could have had a tremendous amount of liver damage develop.  Just because it might take 20 years to get to stage 2 does NOT mean that it will take another 20 to get to stage 4 (cirrhosis).  Something is causing your liver cells to die off at a faster than normal rate and most likely it is the HCV.  

Get the biopsy and find out where you stand.  If you don't choose to do treatment I would say get a biopsy at least every 3 years since you are probably already in the latter stages. You can't just pretend you dont have it unfortunately for us it keeps on ticking while we feel fine and oftentimes symptoms dont come until it's very very late in the game.