High Level of AST & ALT

[Raj185]

Hi,

I'm 29 years Male with chronic Hep B. My HBV DNA levels 2 years back was around 157,000 IU/ML and ALT, AST where under normal limits. Doctor suggested to start the medication with 0.5 mg of entacavir as the DNA levels werr high . Since then my DNA level has reduced to  less than 100 IU/ML for the past 2 years. Also my ALT/AST levels were normal for the same period, but when i got these checked again last month they were high AST -44 U/L ALT -111 U/L. My doctor said that Hep B is not the cause for these high levels of ALT/AST. so he suggested few more tests Lipid profile, ANA-IF,Ferritin and ceruloplasmin. In Lipid profile only HDL cholesterol was low 23 (less< 40) and CHOL/HDL Ratio was high 4.8, ANA was negative, Ferritin was 178.2 ng/mL (range 22 - 322 ng/mL) was normal, ceruloplasmin was normal 0.23 g/L (Rangel 0.2-0.6 g/L).

I don't understand what is the cause for my ALT, AST to be high. Please help.

Thanks
Raj

[stef2011]

i'd suggest to wait 24weeks if you are not having bad sides, are you hbeag positive?

to say peg is working we need at least 0.5-1log decline, in your case 1log decline is less than 10.000iu/ml, best response would be 1000iu/ml

i also think you are not responding to lower or clear hbsag but since hbvdna is und and alt is high i d wait and see what happens between 12 and 24 weeks

[Raj185]

Hi Stef,

My Hbsaq levels is ranging from 16k to 34K IU/ml

HBsAg Quantitative(CMIA)
26/12/14 - 34268 IU/ml
20/02/15 - 16066 IU/ml
03/03/15 -  27602 IU/ml
09/04/15 - 31029 IU/ml

At the start of my pegIntf it was 34K and recent ones is 31K, my doctors suggests to continue with pegIntf only if the Hbsag levels decreases.

He said he is going to access the difference only after 12 weeks, currently 4 more weeks are pending to complete 12 weeks and after that he would suggest whether to continue or not.

With so much fluctuating results , how much difference in hbsag levels from the initial reading should be there to continue with the pegIntf.

I also read on the other threads and some research papers that PegIntf is more effective only if the Hbsag levels are under 1000 IU/ml or low Hbsag, so my question is how does one figure out whether pegintf is having any effect or not on me and what indicators to consider here.

My HBV DNA is still undetected and Both ALT and AST are still high.

[stef2011]

change doctor, not expert

hbsag baseline, 12 weeks, 24weeks and 48weeks

[Raj185]

hi Stef ,

How often do you do the HBV DNA quantitative and hbsag quantitative when you are one pegint considering that I have started just 3 weeks ago.

My docto suggests to look at th wbc count only

[Raj185]

Thanks stef. Will keep you posted on the progress.

[stef2011]

Lighter or no fever at all