ALT and CLESTROL

[asif4338]

HI

I am in 14 week of my treatment for genotype 3 which is negetive after first month of treatment.

my clestrole enzyme is 192  (while desireable is less then 200)

my ALT is not comming down by 70 after 1 month it came down from 250 to 70 but now after 14 injection it is still on 70

my doctor advoice me to take URSODEOXYCHOLICACID 250 mg to bring down clestrol .
and increse RIBAVIRIN dose to 1000mg /day

is it ok to use clestrole tablets in treatment????????


thanks

[jmjm530]

The study you, yourself, just posted clearly makes my case that it's *pre-tx* cholesterol being talked about, not what you suggested, i.e. changes during treatment. I'll avoid -- well sort of :) of the "riba/fat" remark, but again, it's *pre-tx" we're talking about and I've always advocated good eating habits before and post treatment, which btw ironically  I'm not sure so you do or you might emphasize diet and exercise a bit more in your advice as opposed to dispensing Metaformin like candy. As to 140 being "high", it's really "higher" they appear to be saying -- but that aside why they picked such a low level as their high point might be another discussion, but again they're talking about "pre-tx" levels. Also, if you're going to use that number as a sort of relevancy check, then you must apply it to your initial advice in this thread as well.

-- Jim

[CoWriter]

As you know, I researched Urso so I could convince somebody not to take it....LOL

Co

[CoWriter]

Yes, this is true, but my understanding is that it's *pre-treatment* cholesterol, not during treatment.
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If I remember correctly, the "high" on the cholesterol of the people in this study was around 140 and the others had lower levels.  



Lipid Profile May Predict HCV Treatment Outcome.

Higher pretreatment levels of low-density lipoprotein (LDL) and cholesterol may predict successful treatment of patients infected with hepatitis C virus (HCV) according to a study presented at the 2005 Digestive Disease Week (DDW) conference. A total of 107 participants were selected from charts of patients e18 years of age who underwent interferon-based therapy between 1998 and 2004 at Beth Israel Medical Center. Forty-five patients (42%) had HCV genotype-1 (mean LDL 100 mg/dL), 50 patients (47%) had genotype 2 or 3 (mean LDL 111mg/dL), and for 12 patients (11%) genotype was unknown (mean LDL 78 mg/dL). Early viral response (EVR) was achieved in 70 patients, end of treatment response (ETR) in 58 patients, and sustained virologic response (SVR) in 50 patients. Statistically significantly higher pretreatment LDL and total cholesterol levels were found in patients who attained EVR, ETR, and SVR compared with those who did not reach these endpoints. These findings suggest that higher pretreatment LDL and cholesterol levels may be used to predict response in HCV-infected patients undergoing interferon-based antiviral therapy.


Many Genotype 3's have low cholesterol....and SVR raises it....which is an improvement, since we need some cholesterol.  


"The studies show the former but it has yet to be shown, for example, if artificially raising cholesterol (eating sat fats, etc) prior to tx would help SVR. In fact, my hunch is that it might do the opposite as it might raise BMI."
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You mean like the fat with riba.  I totally agree.

Co

[jmjm530]

A secndary point -- and this has been discussed here before -- is whether high cholesterol and SVR are simply associated or causual. The studies show the former but it has yet to be shown, for example, if artificially raising cholesterol (eating sat fats, etc) prior to tx would help SVR. In fact, my hunch is that it might do the opposite as it might raise BMI. And conversly, it hasn't been shown that lowering cholesterol through vigorous diet (or statins) would impede SVR. All that has been shown as far as I know is that there is an association of the two on people with average diets (meaning relativelly high fat in most countries). Prior to tx, I was at one time able to lower my cholesterol to 140 by strictly adhering to the Pritkin (extremelyh low fat) diet. While we will never know, my guess is that I would have become SVR had I entered tx at that time because my *tendency* was toward high cholesterol, again on what might be termed the average American/European diet, i.e. high fat.

[jmjm530]

CO: Tell your doctor that a higher cholesterol level is associated with treatment success....and since below 200 is normal, then you don't need any cholesterol medication.
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Yes, this is true, but my understanding is that it's *pre-treatment* cholesterol, not during treatment.

My pre-tx cholesterol was consistently over 200 (unless under vigorous diet) BUT my cholesterol during tx was around 140-150 due to being lowered by the interferon. My tx was successful.

So at least in my case, a lowered cholesterol during tx didn't impede SVR, although mine was lowered by interferon as opposed to another drug.

That said, I'm unfamiliar with this drug but a quick google shows it's used to treat high cholesterol caused by primary biliary cirrhosis. Is that your diagnosis? Or maybe you have fatty liver that your doc wants to control. Frankly, unless your doc is a liver specialist (hepatologist) I would not start adding drugs to combat cholesterol on treatment, but not because it might affect SVR but because of potential toxicity. So, if you're treating with a Gastro, get another opinion from a liver specialist (hepatologist) is my opinion.

-- Jim

[CoWriter]

Tell your doctor that a higher cholesterol level is associated with treatment success....and since below 200 is normal, then you don't need any cholesterol medication.

Co

[CoWriter]

"Urso is not a cholesterol drug."
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It's not, but it decreases the amount of cholesterol produced by the liver and absorbed by the intestines.

Co

[CockSparrow]

You are a G3. The rise in cholesterol is a good thing, it shows that the drugs are working.

Urso is not a cholesterol drug. Its used for Gallstones and may be used to treat liver diseases such as
primary biliary cirrhosis (PBC),
primary sclerosing cholangitis (PSC) and
cystic fibrosis related cholestasis

so not sure why your Dr wants to give you this.

You cholesterol is nothing to worry about.
CS

[copyman]

Your cholesterol is within normal range. Not quite sure why your doctor would suggest you take cholesterol meds, especially when they can be harsh on the liver and "raise" the ALT?

[Bobby1952]

   Why does he want to bring your cholesterol down. Didn't you ask him. It looks normal to me.  You asked about your ALT on another post and you were told by numerous members not to worry about it. Stop obsessing and just finish the treatment.

Bobby

[lalapple]

hmm. really not sure about this one but thought you deserve a decent answer.  maybe try looking on here in the meantime:  http://hcvadvocate.org/hepatitis/factsheets.asp  they have a lot on drug interactions with tx

good luck, hope the ALT comes down more