Level of ALT, AST

[sam508]

Hi,
My mom just got diagnosis with chronic hep b. Her MD had scheduled for an liver biopsy in few week. Her liver alt and ast result came back are normal. My question is can someone still can get liver scaring with normal ast and alt level?
thanks.

[cajim]

Yes.  What are her other lab readings?

[sam508]

everything else normal

[sam508]

Can you please tell me more, I have been trying to find out her blood works, so far the MD told me that my mom CBC normal, and platelets count as well. thanks  

[cajim]

These tests may reveal liver status:

HBsAg: positive=you have HBV; negative=you are free of HBV
anti-HBs (alias HBsAb): positive=you are immune to HBV; negative=you are not immune to HBV
anti-HBc (alias HBcAb): positive=you have previous HBV or you are recovering from acute HBV
Total anti-HBc: positive=previous or ongoing infection with HBV
IgM anti-HBc: positive=you have recent HBV, less than 6 months and you may be in acute stage
IgG anti-HBc: positive plus positive HBsAg and negative IgM anti-HBc=you have chronic HBV
HBeAg: positive=you have high HBV replication and you may be very contagious
Anti-HBe: positive=you have low infectivity and low viral replication
HBV-DNA: in millions=high viral replication, in ten thousands=mid viral replication, in thousands=mid-low viral replication, in hundreds=low viral replication
ALT (SGPT) range = 5-35, elevated ALT means there is liver damage
AST (SGOT) range = 10-40, elevated AST is related to extent of tissue damage
AFP a sign of liver cancer = normal range is <10, A rising AFP level is usually associated with liver cancer

[zellyf]

ALT - indicates current liver cell death but cannot indicate how damaged the liver is.

AFP is an unreliable indicator of liver cancer.  While levels of over 500 are strongly associated with liver cancer you can have elevations lower than that are related to viral hepatitis.  Also, some cancers do not elevate AFP at all.

[sam508]

So the only way to find out how good, bad, scaring, or not is biopsy?

[cajim]

Biopsy is a test but not the only test or the best test.  Different tests give the doctor different information and one test is not more final than another.

For your mom at this time, HBV-DNA may be more revealing and directive in terms of what to do next.

Best.

[zellyf]

Biopsy is the gold standard for determining the current state of the liver.  Not all doctors will recommend biopsy for all Hep B patients.  Each case needs to be assessed individually.

[sam508]

Thanks for your help, I will find out more on my mom details test result on this Friday, see where things are. thanks