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Hepatitis C, should I be worried?

I am a 31 year old male. I used to be an injection drug user, and I went to rehab and then quit. I haven’t used any drugs in over 5 years since going to rehab. While I rehab, I asked to be tested for hepatitis C. I was told that I tested positive for the antibody. I then went to a hepatologist, who conducted more tests on me, which I think was a viral load test. He told me that I was “undetectable”, and that I didn’t need to worry. This was five years ago, and I haven’t worried about it until the last year and a half.

A year and a half ago, I binged on hard alcohol for 3 days, and then had right upper quadrant abdominal pain for two weeks. It didn’t feel like pain as much as a kind of pressure. It was mild, and 1 or 2 on a scale of 1-10, but constant. It made it hard to sleep. I got worried and went to the ER, and they did a liver function test on me that came back normal. It happened again 8 months ago after drinking too much, and lasted 2 weeks. Again I went to the hospital, and my liver function test came back normal. I have been drinking a lot lately, and I have gotten the pain again. Its just a constant pain, and there even days after I stopped drinking.

These are the liver function test results from a month ago.
Albumin 4.8
Bilirubin Total 0.7
Alkaline Phosphatase 56
GFR >60

My serum electrolytes are normal, as is my CBC results. Should I be worried about hepatitis C, or is this just a result of drinking too much? I was told that I had “cleared” the virus and didn’t have to worry, but I haven’t followed up since then.  Are these standard liver function tests enough, or should I get another viral count or some other test?
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1760304 tn?1316457159
Dear kidpspn,

Pain in the upper right part of the abdomen after an alcohol binge suggests a liver injury secondary to alcohol. However you don't seem to show a liver enzyme elevation and this could be because of co-existing vitamin deficiency. Further it would be better to rule out pancreatitis also.

Anti HCV positivity is seen in people who had HCV infection and in those who have an active infection. HCV RNA positivity is a marker of ongoing infection.

However, if you keep drinking alcohol there can be a re-appearance of hepatitis C virus (HCV) in the blood as alcohol provides the right environment for HCV replication and it increases the possibility of high risk behaviour as well.

I would suggest that you totally abstain from alcohol and get a HCV-RNA test done to know about the status of the hepatitis C infection.

Hope that this information helps and hope that you will get better soon.

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Best Regards,
Dr. Poorna Chandra
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