Elevated AST and Elevated Bilirubin

[tpain845]

Hi everyone,

I'm freaking out, I have done one stupid sexual thing in my life in 2010 and I fear it's coming to haunt me.

http://www.medhelp.org/posts/STDs/Herpes-From-Oral-Sex/show/1309980#post_5992019

After this incident i screen for HIV but not anything else.

Last year during a routine physical I was  told I had elevated bilirubin (I don't have that number).
This year during  a routine physical I had the following numbers: AST 40, ALT 31,  ALP 67 and Bilirubin 1.3.  I'm told the AST is elevated by .3 and the Bilirubin elevated by .1.

My questions are:

- The DR's on this  site state there there is almost zero chance of getting HCV from oral sex, has anyone heard different from a DR?  My Dr. back in the day told me the same thing.

- Could this be a sign of HCV?  How long does it take for HCV to show symptoms?

- I have a 13 month old son now and a pregnant wife, and I'm freaking out!  Can HCV be spread through normal marital sex?

- Is there a good change *IF* my wife has the virus that my son could have it?

[JimmyMose]

More sources for info

This site has extensive info on liver test focusing on AST ALT including likely and more rare causes of elevated results.

http://www.medicinenet.com/liver_blood_tests/article.htm

What Is an Abnormal Result for the Bilirubin Blood Test?http://www.healthline.com/health/bilirubin-blood#AbnormalResults7

I know someone who had slightly high ast alt and Billirubin the cause was hydrocodone, Tylenol and alcohol.  That was about 10 years ago.  Fortunately
they quit before it became more serious.

HCV antibody test is a good inexpensive test for peace of mind to rule out hcv.  The test should be taken at least 3 months after the last event where exposure might have occured.

My personal opinion. Best wishes.

[flyinlynn]

I have had hep most likely since 1979 the first I knew of elevated enzymes was in 1990 at the same time I found out about the hep c. My alt and AST ave been just above normal always sincevthat first test. Less than 100 in all cases even now as I was diagnosed in 2008 with cirrhosis my bilirubin is in normal levels and my ALT AST continue to ge around 50 to 60 range.

Now that I am treating with Harvoni for Hep C both are now in normal range.

Hep c is generally not considered to be an STD especially in long trpeem married couples the CDC does not recommend the need for use of barrier protection in long term monogamous couples so the likelyhood either you nor any family member have hep c as you put it is "theoretical" but so low as to be considered of little concern.

If you are worried get tested. If for what ever reason you were found to have hep c, get treated, get cured.

In either possible scenario you have no worries.

[AWorriedMom]

I think it is just common knowledge. One of the reasons for elevated bilirubin in HCV patients is scar tissue building up and blocking the bile ducts. This doesn't happen in early hepatitis. There are other reasons as well. Since you had elevated bilirubin last year and now have some mild elevations in liver enzymes you really should ask your doc for a hepatitis panel and just find out what is going on. Knowledge is power and there is nothing to be afraid of anymore with the newer treatments. This website may be of help to you:

http://labtestsonline.org/understanding/conditions/hep/start/2

[tpain845]

You are a wealth of information.  Question on the Bilirubin comment you made, regarding elevated levels "usually" present in later stages of Hep C or liver disease as opposed to the beginning. Is that something that is common knowledge or is that documented some place.  I have not seen that fact before.

Thanks again!!

[AWorriedMom]

http://www.liverfoundation.org/chapters/rockymountain/doctorsnotes/pediatrichcv/

In infants born to mothers with HCV, the antibody test is not useful and can give false positive results. The mother’s HCV antibody crosses the placenta like all antibodies and can stay in the blood of an infant for up to 18 months. Thus you cannot use the anti-HCV antibody test to screen for HCV in infants less than 18 months of age. The American Academy of Pediatrics (AAP) recommends testing with the antibody test at 18 months or later since treatment of HCV is not recommended for infants less than 3 years of age. Many families are anxious about the risk of infection to their child. In that circumstance, we recommend testing with the HCV viral test like the HCV-PCR. This should not be done until at least 3 months of age due to a high rate of temporarily positive tests in infants under 3 months of age.

--------------------------------------------------------------
http://www.hcvadvocate.org/hepatitis/Basics/Mother-to-Child_Transmission.pdf

Read under "testing"

--------------------------------------------------------------------
http://www.natap.org/2001/sep/mother_to_infant091401.htm

Passive transfer of maternal antibody accounted for a majority of infants born to women with hepatitis C. The gradual loss of serum anti-HCV in infants occurred by 18 months of age in the vast majority of cases, and many lost anti-HCV earlier, by 12 months of age. Of the 45 studies that described time to clearance of anti-HCV, there were only 3 outlying cases described, in whom clearance of anti-HCV occurred between 20 and 24 months of age.
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I am not going to bother with looking further for you. You can google as well as I can. These statistics that I gave tpain have been well known for a couple of decades. I do NOT make things up.

[dontworry_behappy1]

"Babies born to HCV positive moms are all born with the antibody but 95% of them lose the antibody by the time they are 18 months old because they don't really have the disease"
_______________

I have never heard that before.  Please provide me reference to your
source supporting that statement.

[tpain845]

Thanks all for the helpful comments!

[AWorriedMom]

If your wife has it, the baby would have a 95% chance of NOT having it. Babies born to HCV positive moms are all born with the antibody but 95% of them lose the antibody by the time they are 18 months old because they don't really have the disease.

[AWorriedMom]

You ask great questions. ALT and AST can be elevated within a few weeks of exposure. One third of people with hepatitis C never have elevated ALT/AST. If the ratio of AST to ALT is greater than 1, it usually means there is cirrhosis involved. The reason that more people have higher levels of ALT is that 80% of hep C patients do NOT have cirrhosis. Please do not assume you have cirrhosis because your AST is higher. It takes years for cirrhosis to develop. The average hep C patient with elevated liver enzymes will have elevations about one and a half times the upper range of normal. if you exercised vigorously your AST can be elevated. Muscle gives off that enzyme. So do heart problems and many other things.

HCV is rarely transmitted through marital sex although it is not unheard of. The CDC does not recommend condom use in married couples.

If you do prove to be HCV positive, the treatments are so much easier now. The side effects are pretty minimal, and the duration for treatment naive people is 12 weeks. The treatment is successful in 90-100% of the time. As a dad you cannot transmit it to an unborn child.

I think you should get tested and put this worry behind you.

[jules2551]

This is a really good website that can answer a lot of your questions.

http://hepatitiscnewdrugresearch.com/index.html

[tpain845]

Thank you much for the detailed reply, I appreciate it.  

If you don't mind me asking what is typical for a Hep C. patient to experience as far as elevated enzymes go (very mild like a couple points, or elevations in the 100s).  And how long does elevation typically take (years or tens of years).

I have read in numerous threads now that it is typical for HEP C patients to see ALT levels higher than AST.  And thus ALT levels are a better indication of the virus.  Do you feel that is true?

[AWorriedMom]

Your risk is close to zero. Bilirubib does not rise until late stage disease. There are many reasons for ALT and AST to rise, from alcohol to taking a simple tylenol.  Your ALP is perfectly normal. I really doubt your have HCV unless you have other risk factors. Get tested for your peace of mind.

[tpain845]

Thanks for the reply, I am planning on being tested just for peace of mind.  I just needed some quick reassurance I guess, that I would be at almost zero risk.   On most sites, the risk is specified as theoretical.  Appreciate it.

[Carlhcv]

I read your other thread and the Dr is right. Your chance of getting HCV from oral sex is near zero. The anti-body test is cheap peace of mind though. Other STDs are possible.