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Avatar universal

ALT and AST keeps elevated

Hi,
This is my first post here. I am 32 years old male, living in the United States and I have HBV since birth. Two weeks ago, I started using tenofovir (viread), but my ALT and AST levels are remarkably increasing in the past two months. I wonder if anyone has any explanation for this?

My test results are below and I will keep them updated as I have more test results.

Anti-HBS: negative
Anti HBE: positive
HBS AG: Positive
HBE ANTIGEN: Negative
HBe Antibody: Positive
HBcAb Total: Positive
ANTI-HAV TOTAL: Positive

February 7, 2014
HBV DNA, QN, PCR: 19837 IU/mL
ALT: 46 IU/L
AST: 22 IU/L

May 2, 2014
HBV DNA, QN, PCR: 24047 IU/mL
ALT: 61 IU/L

August 27, 2014
HBV DNA, QN, PCR: 103000 IU/mL
ALT: 78 IU/L

February 5, 2015
HBV DNA, QN, PCR: 5533153 IU/mL
ALT: 238 IU/L
AST: 74 IU/L
Vitamin D, 25-OH, D3: 19 ng/mL
Started using vitamin D-5000 iu

March 4, 2015
ALT: 699 IU/L
AST: 217 IU/L
Vitamin D 25-OH, D3: 43 ng/mL


March 5, 2015: Started using tenofovir (Viread) 300mg


March 18, 2015
ALT: 1340 IU/L
AST: 488 IU/L

13 Responses
Avatar universal
I am not a doctor. Some points for you to consider:
1. your ALT was rising together with your viral load before treatment;
2. you had only started treatment two weeks ago, so is it too early for Viread to reverse the trend? You may like to ask your doctor.
Avatar universal
Interesting that your viral load went crazy up suddenly after all these years
Avatar universal
Thank you for the quick reply. Yes, I know it is still very early for the Viread effect, but I am just worried of these sudden increases at ALT and AST.
Avatar universal
Yes, unfortunately, I was okay for a good time. Then, since the beginning of 2014 my HBV DNA, ALT, AST started increasing. I hope viread will be able to decrease these numbers (fingers crossed).  
Avatar universal
Check your hbeag just to make sure it is still negative
Avatar universal
HBeAg was checked on February 9, 2015, and still negative.
Avatar universal
Usually it will take viread up to 6 months to make hbv dna undetectable. Where you originally from this way we will know your gebotype
Avatar universal
I am originally from Turkey, but I don't know my genotype.
Avatar universal
Ok so you most likely have genotype D just like me since we both from mediterrenean
Avatar universal
Good news, viread worked.
My ALT level is now 20 U/L and AST is 21 U/L.

Avatar universal
What about the virus load? Has it reduce as well?
1 Comments
The current HBV DNA is 38 IU/ml
Avatar universal
useless question of course antivirals make viral load undetectable
1 Comments
Thanks Stef, My current HBsAG value is 4041 and I wonder what does this value indicate (if anything specific)? Is there a certain threshold for this value?
Avatar universal
it just indicates it is too high to clear hbsag by peg or nucs

this said the use of nucs for 5-10years, vit d3, healthy life, immune modulators like gcmaf may lower hbsag.my experience is that when i started nucs hbsag was 5000-7000iu/ml and today by use of nucs, vitamins, gcmaf and peginterferon is 800-1200iu/ml

i guess my hbsg will go very low at 10 years of nucs if i reached such decline by 5 years, also most of the decline by nucs is between 5 to 10 years
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