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Author Topic: Liver Enzymes Elevated Almost 1 Years Out  (Read 15380 times)

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Offline dtre30319

  • Newbie
  • Posts: 2
Liver Enzymes Elevated Almost 1 Years Out
« on: October 06, 2016, 04:21:53 pm »
Hello Everyone,
  I ended Harvoni on September 28, 2015 and complete treatment successfully.  I have had 3,6, and 9-month blood test and all have come back hepc negative.  However, from reading the forms, my liver enzymes should have come down during treatment and remained.  When I asked my doctor he said it can take a while to repair.  My fibrosis scan was 0-2.  Has anyone else liver enzymes not gone down a year after treatment?


« Last Edit: October 06, 2016, 05:14:41 pm by dtre30319 »
Logged
10/6/16: AST -67, ALT-86, Alkaline Phosphatase - 104
7/11/16: AST -53, ALT-47, Alkaline Phosphatase - 100
3/6/16: AST -70, ALT-85, Alkaline Phosphatase - 120
11/15/15: AST -63, ALT-78, Alkaline Phosphatase - 108
8/16/15: AST -68, ALT-71, Alkaline Phosphatase - 109
5/17/126: AST -67, ALT-46, Alkaline Phosphatase - 136
Finished Harvoni September 28, 2015.
I have had 3, 6, & 9 checkup and all bloodwork came back hepc undetectable after the Harvoni.

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #1 on: October 07, 2016, 11:25:32 pm »
What are your liver enzyme test results? I assume you are talking about ALT and AST what are the reference ranges for your lab?
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #2 on: October 08, 2016, 11:56:57 am »
Quote from: dtre30319 on October 06, 2016, 04:21:53 pm
Hello Everyone,
  I ended Harvoni on September 28, 2015 and complete treatment successfully.  I have had 3,6, and 9-month blood test and all have come back hepc negative.  However, from reading the forms, my liver enzymes should have come down during treatment and remained.  When I asked my doctor he said it can take a while to repair.  My fibrosis scan was 0-2.  Has anyone else liver enzymes not gone down a year after treatment?

You should write a signature and include your ALT and AST scores.
  When I first became concerned with my (high) levels (before I was diagnosed),... I asked the nurse, "how high a reading would cause you to become concerned"... she replied  "200 and above"...
I was stunned.
dm
Logged
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #3 on: October 08, 2016, 12:03:51 pm »
Yeah with having hep c our liver function tests tend to run slightly elevated but say someone who is evperinving an acute symptomatic infection will have enzymes elevated welll above normal. You heard 200 I heard 500. An example would be someone very sick with hep A and turning yellow with yellow eyes (jaundice) so along with elevated ALT/AST they would have elevated bilirubin
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline dtre30319

  • Newbie
  • Posts: 2
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #4 on: October 08, 2016, 02:11:00 pm »
Hello,
  My liver enzymes over the year is as follow:

10/6/16
AST -67
ALT-86
Alkaline Phosphatase - 104

7/11/16
AST -53
ALT-47
Alkaline Phosphatase - 100

3/6/16
AST -70
ALT-85
Alkaline Phosphatase - 120

11/15/15
AST -63
ALT-78
Alkaline Phosphatase - 108

8/16/15
AST -68
ALT-71
Alkaline Phosphatase - 109

5/17/126
AST -67
ALT-46
Alkaline Phosphatase - 136


I have had 3, 6, & 9 checkup and all bloodwork came back hepc undetectable after the Harvoni.
Logged
10/6/16: AST -67, ALT-86, Alkaline Phosphatase - 104
7/11/16: AST -53, ALT-47, Alkaline Phosphatase - 100
3/6/16: AST -70, ALT-85, Alkaline Phosphatase - 120
11/15/15: AST -63, ALT-78, Alkaline Phosphatase - 108
8/16/15: AST -68, ALT-71, Alkaline Phosphatase - 109
5/17/126: AST -67, ALT-46, Alkaline Phosphatase - 136
Finished Harvoni September 28, 2015.
I have had 3, 6, & 9 checkup and all bloodwork came back hepc undetectable after the Harvoni.

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #5 on: October 08, 2016, 03:32:41 pm »
Do you know the reference range for your testing?

My old lab was
ALT 0-32 U/L
AST 0-40 U/L
ALK PHOS 39-117 U/L

My new lab has
ALT 6-60 IU/L
AST 5-40 IU/L
ALK PHOS 38-126 IU/L

Your ALT and AST are slightly elevated either way per my labs reference ranges. But your ALK PHOS looks like it is ok.

Per the Mayo Clinic common causes of elevated liver enzymes include:

http://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/causes/sym-20050830

Certain prescription medications, including statin drugs used to control cholesterol
Drinking alcohol
Heart failure
Hepatitis A
Hepatitis B
Hepatitis C
Nonalcoholic fatty liver disease
Obesity
Over-the-counter pain medications, particularly acetaminophen (Tylenol, others)
Other causes of elevated liver enzymes may include:

Alcoholic hepatitis (severe liver inflammation caused by excessive alcohol consumption)
Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
Celiac disease (small intestine damage caused by gluten)
Cirrhosis (early stages of liver scarring)
Cytomegalovirus (CMV) infection
Dermatomyositis (inflammatory disease that causes muscle weakness and skin rash)
Epstein-Barr virus
Gallbladder inflammation (cholecystitis)
Heart attack
Hemochromatosis (too much iron stored in your body)
Hypothyroidism
Liver cancer
Mononucleosis
Pancreatitis (pancreas inflammation)
Polymyositis (inflammatory disease that causes muscle weakness)
Toxic hepatitis (liver inflammation caused by drugs or toxins)
Wilson's disease (too much copper stored in your body)

Are you possibly a bit overweight? A very common cause of slightly elevated liver enzymes is fatty liver. Have they said anything about you having a fatty liver?

My liver enzymes before treatment were only slightly above normal an old result was ALT 74 (0-33 ref range) AST 51 (0-50 ref range) and went into normal range and stayed there since treatment. I have cirrhosis but nothing is currently harming my liver.

Is your doctor a hepatologist or at least a gastroenterologist?

Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #6 on: October 08, 2016, 06:05:07 pm »
Quote from: dtre30319 on October 08, 2016, 02:11:00 pm
Hello,
  My liver enzymes over the year is as follow:

10/6/16
AST -67
ALT-86
Alkaline Phosphatase - 104

7/11/16
AST -53
ALT-47
Alkaline Phosphatase - 100

3/6/16
AST -70
ALT-85
Alkaline Phosphatase - 120

11/15/15
AST -63
ALT-78
Alkaline Phosphatase - 108

8/16/15
AST -68
ALT-71
Alkaline Phosphatase - 109

5/17/126
AST -67
ALT-46
Alkaline Phosphatase - 136


I have had 3, 6, & 9 checkup and all bloodwork came back hepc undetectable after the Harvoni.

Those will probably start coming down.

You're not taking tylenol (acetaminophen) are you?

Taking any supplements?

dm

 
Logged
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline AllShookUp

  • Member
  • Posts: 30
  • "itching like a man on a fuzzy tree" - Not anymore
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #7 on: October 09, 2016, 01:59:58 am »
Weight lifting and other intense exercises can elevate the numbers -

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291230/
Logged
Male - BabyBoomer
1995 - diagnosed HCV
2002 - Peg + Riba - quit after 5 weeks severe anemia
2015 Nov -start 12 weeks Harvoni +Riba + Procrit
Gen 1b - VL 1,500,000 -ALT93-AST143
Comp cirrhosis - enlarged spleen - platelets 35
Week 5 of Tx - HCV undetected - ALT/AST normal
End Week 12 of Tx - HCV UD - ALT/AST normal
Jan. 25, 2016 EOT
April 4, 2016 - SVR10 UD - ALT/AST normal
May 5, 2016 - SVR14 UD - ALT/AST normal
Aug 5, 2016 - SVR28 UD - ALT/AST normal

Offline northfork

  • Member
  • Posts: 57
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #8 on: October 09, 2016, 10:10:38 am »
Check out dragonslayer post re: Hep B reactivation caused by DAA treatments. Even if you tested negative for Hep B, you may have antibodies remaining that could be fired up again.
Logged
Probably infected 1969. Diagnosed 2006. Genotype 1b.
Daclatasvir/ Asunaprevir 2013:relapse
Harvoni 24 weeks 2015:relapse
sofosbuvir, velpatisvir, voxillaprevir  trial started on drug 7/16. Viral load 890,000 approx. F2. Undetected after week 1.
12 week SVR achieved Jan 2017.
SVR 24 achieved April 2017 !

60 weeks post treatment...UNDETECTED!

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #9 on: October 10, 2016, 12:37:17 am »
I read about that. I think they are saying people who are infected with hep b but it is dormant that treating with DAA's could reactivare the hep b virus. From what I understand hep b currently is incurable but it can be supressed. Not my area of knowledge though.
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline dragonslayer

  • Member
  • Posts: 873
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #10 on: October 10, 2016, 08:42:56 am »
Quote from: Lynn K on October 10, 2016, 12:37:17 am
I read about that. I think they are saying people who are infected with hep b but it is dormant that treating with DAA's could reactivare the hep b virus. From what I understand hep b currently is incurable but it can be supressed. Not my area of knowledge though.

I'm confused by this notion of 'dormancy'.  I had an acute bout with Hep B decades ago, and currently test negative for its antigen, but positive for antibodies..  Is this what is meant by 'dormant'? 
« Last Edit: October 10, 2016, 09:52:54 am by dragonslayer »
Logged
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Gaj

  • Member
  • Posts: 172
  • Optimist
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #11 on: October 10, 2016, 08:00:26 pm »
Not an expert and just repeating what I have been told but apparently there are four tests for HBV.

1) Hep B surface antibodies
2) Hep B core antibodies
3) Hep B Surface Antigen
4) Hep B DNA PCR

The group of people at risk are those who have 2) Hep B core antibodies but do not have 1) Hep B surface antibodies. If you are in that group then you have chronic (dormant/inactive) HBV and are at slight risk of reactivation should you clear HCV. The numbers this has occurred to are very small but sufficient that the FDA have required a warning.

Most adults (~90%) who contract HBV will clear it naturally and become immune. If that happens you will have both 1) and 2) antibodies and are not chronic (dormant/inactive). I assume that most who have chronic HBV would have been informed of that by their doctors but it should be easy to check if you aren't sure. 

« Last Edit: October 10, 2016, 08:29:10 pm by Gaj »
Logged
Male - 61 years
Genotype 3a (since 1978?)
Diagnosed 2012
Treated 2013 PEG/Riba/Dac (Relapsed)
F4 - HCC#1 Resected 06/15 - #2 RFAblated 11/15
11/18/15 Commenced Generic Tx - Sof/Dac/Riba (24wks)
Pre Tx = ALT: 270  AST: 209  ALB: 31
05/05/16 = ALT: 34  AST: 32  ALB: 40  VL: Undetected (EOT)
06/16/16 = Relapsed
06/23/16 = ALT: 92  AST: 59  ALB: 40  VL: 290,770
01/12/17 3rd Tx - Zepatier + Sofosbuvir (16wks)
05/03/17 EOT und
06/22/17 SVR7 und
07/27/17 SVR12 UND!
10/26/17 SVR24 UND & Cured!!!

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #12 on: October 10, 2016, 08:09:29 pm »
Yes I agree but if you want to be sure just ask to be tested. I think I would or at least discuss with my doctor.

I am assuming if it did happen it would have happened by now and probably your liver enzymes would be elevated.

Fingers crossed but my best guess is you are probably OK
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline anniemybaby

  • Member
  • Posts: 133
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #13 on: October 13, 2016, 07:52:03 pm »
I'm coming up on a yr post treatment of harvoni I took harvoni for 8 wks and was undetected at 2 wks my Dr is recommending blood work to make sure the beast didn't survive I'm very nervous
Logged
Annie

Offline Lynn K

  • Global Moderator
  • Member
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  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #14 on: October 13, 2016, 10:53:41 pm »
You didn't have any blood testing done after treatment like a 12 week post?
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline brie41

  • Member
  • Posts: 191
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #15 on: October 15, 2016, 06:33:12 pm »
Hi Annie,

  I hope they tested you at 12 weeks at least.  Geez, I would be nervous too.  I also did only 8 weeks of Harvoni and I was lucky to be clear of the virus at my 12 weeks post.  I will be testing in a few weeks for the 6 month.  Best of luck on your test results!!  Brie
Logged
Diagnosed  HCV, 1A 2006
Viral load 6 million
Ast/Alt always in the 20's
F0-F1, never changed
Treatment naive, started 8 week Harvoni 3/15/16
4 and 8 week labs undetected
6 week eot labs undetected
13 week eot UNDETECTED!

Offline FutureThinker

  • Member
  • Posts: 711
  • Onward and upward!
Re: Liver Enzymes Elevated Almost 1 Years Out
« Reply #16 on: October 15, 2016, 07:22:08 pm »
Annie, try not to worry about it until the test comes in.... take a deep breath and stay positive.  Lynn K has a great saying that I have copied on my bulletin board:

"Don't borrow worry and disappointment from a tomorrow that may never come"

We're all w/ you here and let us know the good news when you get it! FT
Logged
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!
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