Acute HCV new blood test results - confused a bit

Original     July 22 -  ALT - 327    AST - 162   ALP- 124

Recheck   Aug 18 -   ALT 124     AST -  155   ALP- 115

Both times Virus at undetectable levels

Liver ultrasound perfect  - no inflammation, lesions, fibrosis

Thank you for any interpretations

Anne

[JennyPenny2009]

The ALT and AST reflect inflammation and possibly liver damage. Tje ALP seems to be in the high normal range. What does the doctor say?

[Anne1717]

Thanks for responding
I am acute or was at the time of the original test 7/23.  The liver ultrasound was perfect - no inflammation or anything else.  I am confused that the ALT went down significantly but the ALT and ALP did not.
I am not being treated yet and will not see the hep doctor until 9/1

[Bill1954]

Hi again Anne--  

I’m unsure of how these results might fit into an acute HCV diagnosis. Take a peek at this page; it discusses liver function tests in some detail, maybe there’s something in there that applies to you:

http://www.aafp.org/afp/990415ap/2223.html

--Bill

[Anne1717]

Hi AGAIN Bill ! - I had previously been to that site AND every other site known to man - thank you.  The source of my angst - actually not an apt description, impatience, is, I cannot see the hep guy at the big time hospital until 9/1 and can only get sparse information from the small town doc here. .  So, I have been relying on the information on this site and what I can find on the internet.

What I do know -  I give blood regularly and so have a time frame of December to June.  I had symptoms late spring - brown urine for one.  I have hypothyroidism and therefore have LFT'S every year which have been better than perfect until this past July.  My bilirubin and albumin are fine as are all the other blood counts.  The recent ultrasound on my liver was perfect. There is no detectable viral load but it was a quantitative test.  The qualitative was negative( This doesn't make sense to me)

The ALT went down between 7/22 to 8/18 from 327 to 124. The AST and ALP did not have as significant of a drop but from what I have read, they take longer to respond.

In my little schematic head, I am just hoping that maybe I am spontaneously clearing  - or else becoming chronic.

I guess I will know soon enough but am certainly glad to pick your brains and hopefully will acquire enough knowledge to give back one day as you all do.

Thanks again,  Anne

[JennyPenny2009]

You say there is no detectable viral load either quantatatively or qualitatively. That means you did clear the virus. I'm a little confused as to what is confusing you. Perhaps your AST and ALP are just a bit behind. You might need to give it some more time.

[Anne1717]

Geez I sure hope so. and thank you for your input

[Anne1717]

Hi - I forgot to say what was confusing me.  The ALT dropped by almost half while the AST and ALP did not have such a dramatic drop.  Perhaps those take longer to recover??

[daytonansb]

Anne,

I am acute too. Contacted it in Mid January. I waited 6 months to see if I could clear it on my own. I didnt so started treatment 5 weeks ago. I went UND in two weeks on TX. I suggest you keep getting  RNA tests to see how your body is coping. Consider treatment by 6 months if you have not completely cleared it. Its your best shot now when acute - like 98% in some studies.

Here is my orig posts

http://www.medhelp.org/posts/Hepatitis-C/Down-24000-IU-to-4000-IU-then-up-to-15-Million-IU-in-6-weeks-No-therapy-either-Somethings-not-right-with-tests/show/1279620?personal_page_id=1755891#post_5858424

Good luck and I hope you clear it on your own.

[Anne1717]

Hey!  I am happy to hear from someone who was also caught in the acute stage. I see the hep doctor for the first time this coming Wednesday.  Of course I will treat if it doesn't clear on it's own but until I see the doctor, I was trying to make sense of the new test results.   Do you know if you are clearing if those numbers might indicate that?   The test weer taken about 20 days apart.

I will check your original posts and thank you for responding,

Anne

[Anne1717]

I read your posts - too bad you did not clear but it sounds like your chances are gret now.  I think I still am in that 6 month window.  We shall see.

Good luck to you andI would like to hear how you are doing

Anne

[Jakied]

here is a little info on your two Pcr tests.  the quantitative pcr measures the

amount of viral load in your blood stream.  this number can be in the millions.

the qualitative pcr tests your blood for the presence of Hep c virus.  does not measure

the amount if any is found.  the qualitative is more sensitive than quantitative for that

reason.  having two undetectable pcr results says you are virus free.  your elevated

alt says you were probably infected with Hcv at some point in the past but were

able to clear it on your own.  that happens, but not too often.

i have a feeling if you were to take the antibody test for Hcv, it would be positive but

that is not a health problem since you are virus neg.

[Jakied]

finally,

     your Alt is coming down because you do not have the virus anymore.  

[Anne1717]

Hi and thank for responding.  I was hoping the decrease in ALT meant I might clear.  I know it is rare but I really have no bad habits except for Ben & Jerry's ice cream. I was a bit confused that the AST and ALP only went down a little.
Cool !
My best to you and your fight, Faye

[Jakied]

Certainly, i am not a MD.  But I know a little about hep c.  I was worried sick a while

back that i was Hcv + but, thankfully, it was a false alarm.  

If I were you, i would ask for the antibody test.  It will probably be pos but your two

neg Pcr tests suggest you are virus neg.  having the antibody is not a health problem

since you are virus neg.  you will probably have the antibody for the rest of your life,

though some people lose the antibody as time passes, usually several decades.

ask your Dr to check your Alt/Ast from time to time.  It should come down to

a range of 20 to 40 or so.  If not, find out why.

[Anne1717]

Hi !  Just happened to be online - What is interesting here -is I know exactly when I became positive since I give blood regularly.  AND  - I am confirmed positive whereas I was not 7 months prior.  The other thing - I am on thyroid medication and therefore have LFT'S yearly which were always in the low  teens.  All of a sudden in July they spike to 327 ALT and 162 AST.. Now the ALT is half that so I agree with you that it appears I am clearing.

So you do not have HCV?

[Jakied]

no, i had a isky exposure a while back, sexual in nature.  i won't lie.  the woman was a

pros.  STUPID!  But what is done is done.  fortunately, the riba test and Pcr were both

neg so i dodged a bullet.  Learned my lesson, for sure.

may i ask what your exposure was?   you certainly don't have to answer.  just curious.

Hcv is not considered to be a Std, as Hbv and hiv are.

[Anne1717]

No known exposure - I am the typical "goody two shoes"  52 years old - no drugs ever, no tattoos, wine with lamb chops, no risky behaviors at all and I am acute so know where I have been in that 6 month period.  I did have a nasty blood tumor removed from my back and tetanus shot - AND even giving blood could be suspect.  So - no known risks.

I am glad you dodged a bullet.   I guess we all do or say something at some point we would like to take back eh?

[Jakied]

yes,   i am sure everyone would like to have a few 'do overs' in their life.

If i were you, i would continue to monitor your Alt/ast level.  I believe both will start to

come down and settle in the 20 to 40 range.  women usually have a lower score

than men.  ask for an antibody test for Hcv.   For me, I would like to know if I had the

antibody.  If positive, this is not a health concern since you are virus neg but you

cannot donate blood anymore IF you are antibody pos.