Concerned w/ Raised ALT and Drop in Platelets

[NashPred]

Here’s a quick history:

Started tx for HCV/HBV co-infection in April with Pegasys/Riba.
Finished HCV tx in mid Sept (GT 2) BUT have continued to take Pegasys ONLY for HBV (Shot 37 is tomorrow).
RVR at week 4 with both B & C VL UND.

Now to my concerns:
3 months into tx, my ALT had returned to normal and stayed in the mid to upper 20’s throughout tx and was still in the 20’s even after being off of the Riba for a month. Everything was looking good and certain levels in my blood work were starting to return to normal. I was feeling better after stopping the Riba but in the last month or 2 I have started noticing more side effects like increased joint, bone and muscle pains, headaches lasting a week, memory loss, and a feeling of Vertigo…..and not the same feeling I had when I was still anemic and had brain fog. I initially chalked this up to the fact that I was still on IFN, increased physical activity at work, and the weather turning colder, but now I’m starting to wonder.

My blood work from last month showed that my ALT had gone from about 26 to 40 but my VL was still UND. Well, today my Dr’s office called with the results of THIS month’s blood work and said that my ALT had gone from 40 to 63 and they were concerned about that and also concerned  that my platelets were very low…I didn’t ask how low, but during combo tx they never got lower than the mid 90’s.

They asked if I had started taking any new medication or had drunk any alcohol…. I have not.

What could cause this raise in ALT and drop in platelets? I really haven’t done anything different other than stopping the Riba at the end of HCV tx and increased physical activity now that I’m no longer anemic. Could all this be related to the IFN that I’m still taking?

They want me to come in next Monday to re-test the blood work.BTW…they didn’t run any VL test this month so I hope they will run them when I come in for a re-test next Monday.

Any thought’s suggestions or comments on what may be going on here? I’m just a little concerned because all through tx my blood work has looked pretty good for the most part.

[JennyPenny]

Please do NOT take Motrin as it is the same as Advil.

[Deb_c430]

mm what about a higher dose motrin? percocets are a oxycodon.   I have 800 motrins when things are really bad,  it is a hard question to answer.     take care nash

[NashPred]

When I was still on Peg/Riba combo tx for HCV, the Dr Rx'd me 2 Percocet a day which worked great and my ALT stayed in the 20’s. Now that I’m back at work, I don’t want to take the Percocet because I have a lot of driving to do so I switched to Advil during the day and my ALT started to rise. Maybe I’m better off just taking a Percocet to get me through the day. I can get by on a lot less Percocet than I can Advil. Hopefully all these aches and pains will improve in March when I come off the Peg and I will not need to take this stuff anymore.

[Deb_c430]

can you switch to tylenol or motrin for a while, My alts have increased on   tx,  many folks do, hang in there,    

Deb

[NashPred]

Thanks all…..I’m gonna keep my fingers crossed that it is all related to the increased Advil intake and looking back, I’m sure that I have taken as many as 8 Advil in one day…..I know that isn’t good, but it was either that or not be able to work.

The raise in my ALT level is the one that scares me the most, but as long as my VL stays UND, I’m happy. I will work on cutting back on the Advil. The sad thing is that Tylenol doesn’t work at all and Advil doesn’t really help as much as I need it to.

I was unable to work while on Peg/Riba combo tx. Now that I’m only taking Pegasys tx and have started working again, the aches and pains can be twice as bad as they were while I was still on combo tx.I only hope that when I finish taking the IFN, that some of these aches and pains will go away or at least diminish to a more controllable level.

[stevenNYer]

Since it suddenly just showed up on your radar, I'm guessing it's the Advil you are taking.    Ibuprofen like Advil could interfere with platelet production and elevate ALT.  And since a Hep liver could be extra sensitive to meds, so I'm putting my bet here.

I mean the other concern is the Hep / cirrohsis, and with your treatment and good response, it doesn't fit your lab trend.

[zellyf]

And it can raise your ALT.  Could that be the problem here?

[salvo]

I just learned that advil will knock down your platelets, because I didn't understand why they say take Tylenol so I asked.

[NashPred]

Let me also add that I had been taking more Advil (about 4 a day) for the aches and pains to get me through the day at work.