Viral Load v. AST, ALT

Grade 2, Stage 2, Geno 1b, 55 yo, currently in treatment.

In week 8.  VL has gone from 22.1 million to UND by week 8.  However, AST and ALT are back up.  AST in week 6 was 44, now 53.  ALT was 37 in week 6, now 53.  Cause for concern?

[Jakied]

Your increase in alt/ast is so small your hep doctor probably wouldn't say a word about it.

On the bright side, you have an 'Evr' (early viral response) which is a good predictor of 'Svr,' (sustained viral respose) which is the magic word 'cure.'

Focus on the positive.

[sunspot]

Not yet. AST/ALT goes down for most folks but not all. If it continues to be high or higher, I would call the doc.
A big congratulations on your VL reduction. UND at 8 weeks is a real nice indictor

[mremeet]

My enzymes were all over the place during treatment (and much higher than yours at times), and I'm SVR now. Minor enzymes fluctuations like what you've experienced mean nothing by themselves during treatment. Pegasys has been shown to cause a benign elevation in liver enzymes during treatment in many people, again it does not forbode a relapse all by itself. I've seen many people fearfully report elevated enzymes during treatment (or above normal at least), worried that it indicated a return of the virus...and yet many of those people went on to SVR just fine. So relax, and look toward your PCR alone to see if you've experienced a viral rebound during treatment.

[Terrylee8]

I'm told that the tx drugs occaisionally cause and alt/ast spike, let's hope that's the case.

[debnevada]

my ast and alt are now more than twice normal in week 28+.  My VL's have been undetectable at week 2, 11, 18, 24.  Dr. Gish says it is the treatment itself that is causing the rise.

i wouldn't worry. but i remember that when it went up a few weeks back, it scared me too.

deb

[FlGuy]

You job is the meds and staying undetectable.  Forget the ast/alt for now. Narrow your focus to getting through tx, dealing with the junk that comes your way, being mindful of work and family.  Let the doc worry about the enzymes, you've got enough going on.

[alagirl]

Your alt is within normal ranges and your ast is not that much higher (dependent, perhaps on the lab you use as different ranges may be different).  everyone who has said liver enzymes go up and down is right.  Plus, you are talking about very small increments.  

Also, I would think, and this is just a guess based on conjecture, but it would seem to me that the medication might work the liver too and cause enzymes to go up sometimes?  Anyone know?  I'm asking for both you and myself.  I know that some medications are more toxic to the kidneys and some to the liver, but I'm not certain about the tx we are currently on, which organ it might affect more.  Others may have more info on that because I haven't read up on that.

[alagirl]

Oh.  Duh.  LOL Deb already answered that.  Hello.  I am just a walking dead person lately.  Brain dead that is...