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Can TDF 300 increase AST/ALT levels during the first 3 months?

From November 2015 my mom has started taking ETV 0.5 + TDF 300 daily after becoming resistant to both LAM and ETV. Her hbv-dna viral load in november was 250000 iu/ml and sgot,sgpt levels were 41 and 40 iu/ml but now after 3 months her hbv-dna viral load has drastically reduced to 530 iu/ml while sgot and sgpt levels have increased to 65 and 84 iu/ml respectively....Now my question is inspite of the dna level been reduced so much why the ast/alt levels have increased?Is it due to tenofovir or something else?
8 Responses
Avatar universal
if one is lucky alt increases because immune system can see infected cells which are cleared and hbsag may go down, this will last little anyway on antivirals and they will go down

alt 65-84 is not high
Thank you stef for your reply.....that means there is nothing to worry about that sudden flare...i hope the treatment is going in the right direction after getting multi-drug resistant due to some ignorant doctors.....
Avatar universal
keep the combo of both even when hbvdna gets undetectable so you are sure you will never develop any other resistance because both drugs protect eachother
To Tom2013
As stef2011 just said , it's perfectly true .
But ,does  she  drink alcohol even occasionally? You said :''after becoming resistant to both LAM and ETV.'' Control her fibroscan ,aghbs quati , Bilirubin, Albumin , GGT and ALP ( Alkaline phosphatase) .
Drug resistance in some organisms sometimes developed fibrosis when there's an increase in alat .
No she has never taken alcohol in her life.....actually she was prescribed lamivudine at the start of her treatment by an ignorant doctor.Eventually she got resistant to it after which she was switched to entecavir 0.5.The initial response was satisfactory but after an year the viral load rebounded and etv+tdf combo was started....The sgot,sgpt levels remained low at the time of etv resistance.Now bilirubin,alp,albumin all are within normal ranges only the sgpt,sgot levels have become partially elevated.
In India many of us do not take alcohol.....we maintain a standard and healthy diet....My family is a vegetarian.
Avatar universal
That's good nutrition for a healthy health. Now ,check for fibroscan , don't neglect it .
Avatar universal
Is there any sicentific evidence that hbv patient on antiviral drug and has higher alt  Has a higher chance the clearing the virus?
Myself went through lamivrdine and hepera, got resistance, then went to viread, and my alt was always higher than normal, sometime as high as 150 to 200 at a time,  and been fluctuating in 60 to 80 , and dr was very worried, asking me many times if i have any joint inflammation before hbv went undetectable, and now i have hb anti-body, and alt finally came down to 47.
Avatar universal
What hb antibody ? You mean anti-HBe I guess ?
Avatar universal
Sorry sorte for the confusion, i am not very technical on these medical terms, the blood report from hep b quant pcr read hepatitis b surface ab positive.
Avatar universal
Surface Ab or surface Ag ?
Hi sorte, the report just read Heatitis B Surf Ab,
here is a link picture extracted from the report
Avatar universal
it looks like you cleared hbv definitively but there is a mistake in the tests, hbsab must be quantitative, never qualitative

repeat hbsab quantitative

antivirals must be kept even if hbv is cleared for at least 12 months

do you have fatty liver?are you overweight?
Hi stef2011,
as I said earlier, maybe I extract text out of context and omitted other information on the report
I went and took picture of both 2 page of the report

here is the link



the report did said about clerical error on something, and I do have 2 blood report (June 2015 and December 2015 on hand stating responding to Hep B surf Ab)
the dr also suspected about fatty liver, did liver biopsy 2 times in 5 and 8 year ago, and ultrasound every 2 or 3 years, came back normal. I am 5'7" 150 lb, never drink or smoke, (used to be only 125lb right after undergrad)
I've stopped taking the pill for two weeks now, didn't notice any changes in body, will do another blood work in 6 months and revisit dr.
Do leep us posted. We are motivated by these success rates of antivirals...
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