compare two liver enzyme screenings

[medquestion788]

I've had two liver enzyme screenings separated by 2.5 months.  First screening revealed elevated AST (69), ALT (101), and GGT (97).  The second screening revealed elevated AST (58) and normal ALT (27) and GGT (14).  My provider believes these results are positive, but by concern is my current AST to ALT ratio (58 to 27 is 2.15).  After some online research, most references agree that a greater than 2:1 ratio is normally a sign of cirrhosis.  Aside from these tests, I am asymtomatic.  Is my AST:ALT ration something to be concerned about?

[mikesimon]

With a gallstone which involves a bile duct generally the direct bilirubin and alkaline phosphatase are elevated along with AST and ALT.
There are ways of diagnosing this problem.
Abdominal Ultrasonography is probably the first step. Did you undergo ultrasound?
They can also do ultrasonography though endoscopy.
When you say that you still have HCV but are SVR that is a controversial issue.
A recent article suggests that SVR does mean cured.

"Conclusion: This long-term study evaluating 157 patients demonstrated that SVR assessed by TMA is durable, and HCV antibodies were markedly decreased (mainly those directed against the non-structural proteins), emphasizing an absence of ongoing infection. These results strongly suggest that HCV infection cured in patients who achieve an SVR."
See:  http://www.medscape.com/viewarticle/706006?src=mp&spon=3&uac=39980BG


Nevertheless I know that there are still experts who believe that the virus persists at low level in SVRs. But, most people like to believe the virus is eradicated. One thing does appear to be true - SVR is durable and the virus does not become serum detectable even after long periods of time.

Good luck,
Mike

[twinkook]

I've had bloodwork due to doc thinking I passed a gallstone and my liver enzymes went up to 277/266 :(  Scared the heck out of me. I had Hep C and still have it, but I've been SVR for the last 4 years. I thought I may have relapsed due to this happening. I don't see anything on my bloodwork that say's GGT? My Bun/Creatinine ratio was circled and they have been doing weekly bloodwork and my enzymes are back to normal again, Thank God, but the kidney's are not doing too good getting back to normal :(  7 other things with my bloodwork are flagged either high or low.  Do you think this is all normal for passing a stone and it being lodged in the liver duct?

Thanks For Your Help,
kook

[mikesimon]

I wouldn't worry at all about the ratio. With a normal ALT I don't think the ratio applies to you. Be patient and stay liver friendly and perhaps all of your numbers will normalize. Exactly why your numbers decreased is another issue. Did your behavior or medications change?
Mike