On a relapse how long does it take for ALT and AST to rise

[Bill200]

How long, once treatment ends and relapse occurs, does it take for the ALT and AST to begin to rise?  I've seem to recall that it takes about 3 or 4 weeks.

[BoceprevirGal]

  Well, my AST/ALT history has been this:  they were always about 2 times higher than normal range, for the 20 yrs that I knew I had Hep C.  
   Last year, I went in for my Yearly Physical, and my enzymes were 10 times higher than normal range. And the same time, I also noticed that my platelets had slid below normal, for the first time. The platelets were actuallyon the borderline (150,000) last July, and by October they were down to 120(000).
They were still down at 120,000 in December, and I took a FibroTest that had me at a cirrhotic score. My Alpha-2Macroglobulin was Higher than normal, my Haptoglobin was lower (this was on the Special Chemistry panel).
    I had a biopsy, and I was at Stage 2, and went into Tx, in early Feb.  At four weeks into Tx, once I cleared the virus, my ALT/AST stayed within the normal range, the whole remaining 24 weeks on my Tx.
    I am still waiting, 2 months post Tx, to get any labs done. Who needs
those silly old labs anyway?  I actually dont feel like getting anymore labs done, labs can bring gloomy doomsday news ;/

[Bill200]

Mine ALT/AST were very high but unlike Will's case, damage was occurring quickly - verified by biopsies.  

I have blood tests nearly every week.  Probably not a good thing in one respect.  I breathe a huge sigh of relief when they come back normal.  Then on Wednesday or so the anxiety starts to build again, and I get labs Thursday and the results later that day usually.  I tell myself it's silly to get wrought up about it but, well, it is a big deal.  When they are good I kind of go on a good mental vacation for a few days from all this.

This Thursday I'll have a VL test and that can take a week to come back so they'll be a week of kinda keeping myself wound down.  :0

I know, just live every day and I'm pretty good at that but if I'm honest with myself some or a lot of the good attitude is predicated on things working out okay.  All we can do is all we can do right.

[willbb]

very mold fibrosis.
-------------------------

yikes ...lets hope I don't have "mold" fibrosis....meant    "mild"  :)

Will

[willbb]

Hi bill..

ceanthous.has said it best IMO..
Liver enzymes are only one markers to signify that there may be inflammation or injury happening to the liver. They are extremely variable.One person cam have HCV for decades with relatively normal enzymes while another might have HCV for only a short time with very high markers.
Personally I have had quite high AST &ALT for many years and still have very mold fibrosis.

Bottom line the only marker to signify possible relapse is a PCR.

Best ..
Will

[frijole]

Unless you have weekly bloodtests post tx, how would youknow?  beeblessed posted a question about how long it takes to relapse a couple of weeks ago and I will look for that post.

I am one of those persons that OH mentioned who has always had liver enzymes in the normal range - mine were 20-30  (yet I still achieved cirrhosis) - but when I relapsed after my first tx, my ALT and AST were 52 & 58 at 10 weeks post and 83 & 114 at 16 weeks post.  Then they settled back into that 20-30 range.  After completing triple, they were 17 & 9 -- lowest ever.  So far so good.  I will get my 12 week post tests this week.

[orphanedhawk]

I think a lot of it has to do with the health of your liver. I have a freind with hep C who always has low ALT and AST levels, within the normal range but low, her liver is undamaged despite having hep C for 20 years.

[ceanothus]

I really doubt there is a good answer to this question, as the enzyme levels are so variable and unpredictable. My own enzyme levels have varied a lot without any recognizable pattern.