what is the cause of elevated bilirubin levels in liver function test while AST and ALT decreasing?

what is the cause of elevated bilirubin levels in liver function test while AST and ALT decreasing?
i m suffering from hepatatis A since jan 6.i did my liver function tests on january 12.The readings were:
TOTAL BILIRUBIN-5.54 mg/dl
AST-3600 U/L
ALT-4200 U/L
alkaline phosphatase-157 U/L

so my doctor advised me 2 take Ursocol-300 and told me 2 take rest.
i again went for a liver function test on jan 23(after 11 days) just to check where i stand...the readings wre:
TOTAL BILIRUBIN-8.69 mg/dl
AST-171 U/L
ALT-292 U/L
alkaline phosphatase-117 U/L

This shows that my ast and alt levels r returning 2 normal.that means my liver is functioning better.But why is my bilirubin level increased to 8.69 mg/dl.My eyes hav turned yellowish.can someone give me an explanation?????will my bilirubin level further increase???

[mikesimon]

First you should know that I am not a doctor or in the medical field. What I know is from research and my own experience.
My understanding is that your situation is not uncommon with Hep A.
Hep A usually resolves without treatment and confers lifetime immunity against reinfection.
Elevated bilirubin is often associated with biliary issues so you could undergo an ultrasound to rule out a biliary blockage or obstruction if that test is available to you.
I hope this resolves quickly and positively.


Her is an excerpt from an article titled:

Clinical Manifestations of Hepatitis A: Recent Experience in a Community
Teaching Hospital

It should give you an idea of what to expect. Although your peak numbers for AST/ALT were higher than normal they seemed to be declining on schedule. I hope you will be somewhat relieved by the excerpt but please read the entire article.

The link is:

http://www.kliinikum.ee/infektsioonikontrolliteenistus/doc/oppematerjalid/Referaadid/A_hepatiit.pdf


"...Laboratory tests. The mean presenting laboratory tests from 59 hepatitis A patients included total bilirubin of 5 mg/dL (mean peak. 7 mg/dL). alkaline phosphatase of 269 units/L(mean peak. 319 units/L). serum AST of 1442 mlU/ mL (mean peak. 1754 mlU/mL). and ALT of 1952 mlU/ mL. Atypical lymphocytes were noted in 7%- of the patients. Three patients had bilirubin levels of >20 mg/dL (highest, 38 mg/dL). 2 patients had serum AST values of >5000 mlU/ mL (highest. 9987 mlU/mL). and 6 patients had serum ALT levels of>5000 mlU/mL (highest. 9711 mlU/mL). Linear regression analysis of peak total bilirubin versus age indicated that bilirubin levels during acute hepatitis A increased with advancing age (P < .001). Bilirubin levels returned to nearly normal by a mean of 5.3 weeks (range. 0.5-33.0),
alkaline phosphatase became normal by a mean of 5.3 weeks (range, 1-14), and serum AST and ALT values reverted to normal by a mean of 6.2 weeks (range, 0.5-29.0) and 7.4 weeks (range, 1-29), respectively.

Recovery. About two-thirds of our patients recovered within 2 months from onset of illness. Eighty-five percent were symptom-free with normal liver tests by 3 months, and nearly all were normal by 6 months. Only supportive treatment (diet, bed rest) was recommended during the course of the acute illness...."

Good luck,
Mike