Author Topic: Elevated liver enzymes after Vosevi? (Read 17030 times)

Maxima · « **on:** January 18, 2019, 10:36:57 am »

Hello,
I finished vosevi 6 months ago, SVR, cured!

During nearly 30 years of infection GGT was nearly normal, now 10fold elevated.

My doc says it's normal. Ultrasound was o.k.

Is there any idea or similar experience?

I thought all enzymes should be in normal range.

Thanks for any idea...

Maxi

lporterrn · « **Reply #1 on:** January 18, 2019, 01:37:43 pm »

Enzymes should be in normal range. There are many causes of an elevated GGT. Excess alcohol use is the most common. Definitely follow up on this. If your doc persists in saying it is normal, get a second opinion.

Maxima · « **Reply #2 on:** January 18, 2019, 01:43:43 pm »

Thank you for answer.
No alcohol and very healthy diet.

I had many unusual side effects.

Yes, I think I'll get a second opinion.

lporterrn · « **Reply #3 on:** January 18, 2019, 04:28:53 pm »

By any chance, do you know if your cholesterol is elevated? Did you start any new medications in the past 6 months? Are your other liver enzymes normal? Is your weight normal? Any GI problems? The GGT could be from a gall stone or gall bladder problem - this is common and sometimes patients think they are having drug side effects when in fact they have an undiagnosed gall bladder problem.

Lynn K · « **Reply #4 on:** January 18, 2019, 06:00:03 pm »

Found some info. I would get a second opinion for a 10 fold above normal result. My liver enzymes were slightly elevated before I was cured. Since cured my results have been normal with the exception of last summer when I broke my wrist and was taking aleve for a week.

“What do the results mean?

Your results from the GGT test should be available the following day. Your doctor will help you interpret them and assess if they’re in the normal range or not. According to the Mayo Clinic, the normal range for GGT levels is 9–48 units per liter (U/L). Normal values can vary due to age and sex.

The GGT test can diagnose liver damage, but it can’t determine the cause. If your GGT level is elevated, you’ll probably have to undergo more tests. Generally, the higher the GGT level the greater the damage to the liver.

Some of the conditions that result in increased GGT include:

overuse of alcohol
chronic viral hepatitis
lack of blood flow to the liver
liver tumor
cirrhosis, or scarred liver
overuse of certain drugs or other toxins
heart failure
diabetes
pancreatitis
fatty liver disease
GGT is often measured relative to another enzyme, alkaline phosphatase (ALP). If GGT and ALP are both elevated, doctors will suspect that you have problems with your liver or the bile ducts. If GGT is normal and ALP is elevated, this could indicate bone disease. Your doctor may use the GGT test in this way to rule out certain problems.

Is the GGT test always accurate?

GGT is sensitive to fluctuations. If your doctor thinks your temporary use of medications or alcohol is affecting the test, they might want you to be tested again. Barbiturates, phenobarbital, and some nonprescription drugs can increase the levels of GGT in your body. Levels of GGT increase with age in women, but not in men.

If you have recently stopped drinking heavily, it can take up to a month for your GGT to fall to normal levels. Smoking can also increase your GGT level.”

https://www.healthline.com/health/gamma-glutamyl-transpeptidase#test-accuracy

Maxima · « **Reply #5 on:** June 29, 2019, 04:15:21 am »

Thank you for your answers, sorry for the long time,

No alcohol, no drugs, neither smoking, neither fatty meals nor unnecessary medicine.

The rise of liver enzymes first time after harvoni relapse, rising over weeks and months.

Before Harvoni my liver enzymes were in a nearly normal range.

Still HCV free, many tests were done.
Cirrhosis and HCC suspected

Computer totomography and ultrasound, many blood tests were done (university hospital).

Slight fatty liver was the only finding, to my great relief .

Still muscle cramps and no appetite, better in the evening. Feeling of sickness every morning.
Can you imagine my depression and mood swings?

I am still losing weight.
Platelets were rising, about 90.000.
A specialist was consulted, no reason for worrying he said.

Gastroscopy in December without findings.

Colonoscopy and gastroscopy (repeated) next Friday, to be on the safe side.

I'm curious if there is any experience with these unnormal effects and symptoms.

I'm wondering if there is any correlation between loss of HCV in the system with fat metabolism, autoimmune disease and so on...

(Sorry for my English.)

Lynn K · « **Reply #6 on:** June 29, 2019, 01:17:33 pm »

Platelets rising is a good thing normal is above 125 yours are 90 caused by cirrhosis. Improving platelets are an indication of the liver beginning to heal.

People who are only slightly overweight can also develop fatty liver. The fat in the liver irritates the liver and causes liver enzymes to rise. Normal BMI is less than 25 above 30 is obese. A person who is 5 feet 4 inches and weights more than 145 pounds in overweight over 170 pounds is obese

Maxima · « **Reply #7 on:** June 29, 2019, 03:38:30 pm »

No cirrhosis.
Cirrhosis was suspected according to low platelets, etc.
Before Vosevi and after Harvoni, platelets were 115....

My BMI now is 23, a year ago my BMI was 25.

Before therapies, during all my life I was overweight.

Now I am nearly thin.

Lynn K · « **Reply #8 on:** June 29, 2019, 05:22:40 pm »

How did they diagnose you don’t have cirrhosis? Did you have a liver biopsy, or AGI roscan test or a blood test called fibrosure? Those are the only ways to diagnose cirrhosis. An ultrasound can see signs but can’t really rule cirrhosis in or out.

Having carried that extra weight could have contributed to fatty liver congrats on the weight loss hopefully since you are now in normal range the fatty liver will begin to improve.

Lynn K · « **Reply #9 on:** June 29, 2019, 05:26:15 pm »

The causes of low platelet production include:
aplastic anemia.
vitamin B-12 deficiency.
folate deficiency.
iron deficiency.
viral infections, including HIV, Epstein-Barr, and chickenpox.
exposure to chemotherapy, radiation, or toxic chemicals.
consuming too much alcohol.
cirrhosis.

Maxima · « **Reply #10 on:** June 29, 2019, 05:40:35 pm »

Thank you Lynn.
Blood was checked by a blood specialist (oncology) to exclude a severe blood disease.
B12 and folate were in normal range.
HIV excluded, as weil as reactivation of HBV.

Iron too high, typical for liver disease.

Absoluteley no alcohol.
Fibroscan (Arfi?) before Harvoni was o.k.

Epstein Barr could be a reason.
Assuming HBV could be reactivated, I guess, other viruses as weil. They said maybe "infection"....without knowing which one.

My condition improves very slowly.with many steps back.
Vosevi was finished in April 2018...

I'll keep you informed.

Thanks a lot!

Maxi

Maxima · « **Reply #11 on:** September 20, 2019, 03:23:41 am »

Hello all,
update:
New endoscopy in July 2019 showed esophageal cancer!

Currently, I'm on radiation.
Unfortunately, due to low platelet count, no chemotherapy is possible.

...

Surgery is planned within 6 to 8 weeks.

Liver enzymes (GPT) is nearly normal in the meanwhile.

I hope that platelets recover.

Another elastographie showed 13.6 kPa.

Does anybody know how long does it take for platelets to recover?

Vosevi finished in April, 2018.

Best, M

Lynn K · « **Reply #12 on:** September 20, 2019, 04:32:32 am »

So sorry to hear of your struggles I hope your healthcare team are working hard on your behalf.

Low platelets are caused by liver cirrhosis. Because of the scarring of the liver this causes increased pressure in the main vein in the liver the portal vein. This is called portal hypertension. Portal hypertension in turn causes the spleen to enlarge and sequester (hold on to) platelets. The only way to improve platelet counts is to reverse liver cirrhosis. Since I was cured of hep c in 2015 my platelets that were around 85 before treatment have risen to about 125 now four years later. Still below normal but improved. Otherwise there are some medicines that can increase platelet counts or blood platelet transfusion can temporarily raise platelet counts.

Maxima · « **Reply #13 on:** September 20, 2019, 05:24:11 am »

Thank you Lynn.
Early this year, platelets were under 80, in July nearly 120...when therapy started, platelets fell to under 90.
They at least should be 110 for chemo. One week before, they tried a 50% Chemo....platelets fell again to under 80.

So, chemo was cancelled. They try an antibody now.

Never thought that there are such struggles once the virus is killed.

My healthcare team is very experienced.

I hope, if I need chemo in the future my liver is much better.

So, time is on my side.

Best, M

Lynn K · « **Reply #14 on:** September 20, 2019, 03:17:11 pm »

Best of luck maybe they could support your platelet count with a drug?

Found this article about thrombocytopenia has some interesting information

https://www.webmd.com/a-to-z-guides/thrombocytopenia-symptoms-causes-treatments

KimInTheForest · « **Reply #15 on:** September 22, 2019, 01:18:34 am »

Good luck to you Maxima! Very sorry to hear about your esophageal cancer diagnosis. But at least your doctors and you now know what's going on and can find some way to address it.

Like you, I have had major health struggles that began immediately after I finished treatment in 2015. Two different cancers emerged - one emerged while I was still on treatment. (I always thought there was a connection to the treatment.) Somehow I am still here and relatively okay 4 years later. I am wishing the very best for you. Will keep you in my thoughts. Strength to you!

Kim

Maxima · « **Reply #16 on:** September 22, 2019, 06:37:51 am »

Thank you both.
Kim, I think like you that these blessed antivirals have something to do with cancer, especially when long infected with HCV.

Luckily, it's not HCC.

I started Harvoni December 2015 with F2 and platelets in a normal or near normal range.

Vosevi left me cured from HCV, with nearly F4 and platelets too low for chemo. I never really recovered.

Fortunately, vosevi left me sensitive enough to be very sure that something is going completely wrong.

So, esopheagal cancer could be diagnosed in an early stage. Radiation and surgery will do.

Most often it's too late.

The platelets will recover together with my liver, at least I hope so. No other condition was found.

Yes, we keep strong!
Healthy diet and healthy lifestyle will help.
I believe in God. HE helped me find out.

My prayers are with you.

M

KimInTheForest · « **Reply #17 on:** September 22, 2019, 12:53:56 pm »

So very glad to hear your esophageal cancer was diagnosed early!

kim

Maxima · « **Reply #18 on:** September 22, 2019, 01:27:13 pm »

Oh yes!
I had no disphagia, only weight loss and nausea, but not all the time. Enough for being suspicious.

Doctors and me too thought of ongoing side effects of Vosevi. They searched for HCC. CT in February was clear.

I did not trust.
2nd endoscopy in July showed cancer.

I do not google for statistics.
They are outdated.

Hope you are cancer free and healthy?

KimInTheForest · « **Reply #19 on:** September 22, 2019, 01:35:00 pm »

The reality is none of us is ever actually cancer free or ever will be. Cancer cells are emerging and being dealt with in every body all the time. Was important for me to recognize that fact to move forward with my own health journey. Otherwise I am holding out for a goal that is unattainable by known science and human physiology. l.

In my case I am currently in remission from 3 different cancers (which is not the same as cancer-free or cure, because those conditions don't actually exist in anyone). All of my 3 cancers arose in sequence during and/or shortly after I finished my Harvoni+ribavirin treatment in 2015. I'm enjoying my life.

kim

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Author Topic: Elevated liver enzymes after Vosevi? (Read 17030 times)