I have known I had Hep C for 4 years, have not done the treatment, but I am now considering it. My enzymes are always fairly normal and my biopsy was a 2, 2 yrs ago. I recently had an ammonia blood test and it came back 192 where the range of normal was 19-87. I am experiencing no symptoms of hepatic encephalopathy. My doctor is starting me on lactulose, and wants me to start treatment for the HCV immediately, he now says the 2 on the biopsy could be wrong "the liver is a large organ, we may not have gotten a good sample" his words. My question; is this blood ammonia test an accurate indication of liver damage? No one has ever done one before, and are there things that could make it that high with out it being liver related?