fibrosis and alt

[pong58]

An increasing alt can lead to fibrosis?

[flyinsky]

Sorry I meant true

[flyinsky]

You are try Stephen and the second case is mine and This what doc told me and she wishes to put me under peginter to reinforce my immune sys since my viralload decrease

[StephenCastlecrag]

I hope I got it right.

Inflammation is part of some immune responses, but there are immune responses, such as non-cytotoxic T cells response that can degrade cccDNA without inflammation.
Generally, ALT rises preceded by rise in HBVDNA is bad, however, ALT rises followed by fall in HBVDNA may be good, an indication of attempt and success of viral clearance.
I am sure the picture is more complicated because all ALT flares are immune responses, that may or may not lead to successful clearance.

[pong58]

How to distinguish if increase in alt is cause by Inflammation  or immune respnse?

[StephenCastlecrag]

When a liver cell dies or is damaged, the ALT (an enzyme) within the cell is released. So a high ALT means more liver cells are dying or being damaged than normal, as a result of inflammation and immune reactions. Dead liver cells must be replaced by new cells. If massive number of liver cells are constantly dying (persistent elevated ALT), the growth of new liver cells may be irregular and uncontrolled, leading to scarring(fibrosis). Over a long period of time, scarring gradually replaces healthy liver cells and changes the architecture of the liver, thereby affecting its proper functions.