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Author Topic: Elevated liver enzymes after Vosevi?  (Read 2187 times)

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Offline Maxima

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Elevated liver enzymes after Vosevi?
« 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

Offline lporterrn

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  • LucindaPorterRN
    • LucindaPorterRN
Re: Elevated liver enzymes after Vosevi?
« 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.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
http://blogs.hepmag.com/lucindakporter/

Offline Maxima

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Re: Elevated liver enzymes after Vosevi?
« 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.

Offline lporterrn

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  • LucindaPorterRN
    • LucindaPorterRN
Re: Elevated liver enzymes after Vosevi?
« 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.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
http://blogs.hepmag.com/lucindakporter/

Offline Lynn K

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Re: Elevated liver enzymes after Vosevi?
« 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
« Last Edit: January 18, 2019, 06:02:14 pm by Lynn K »
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 Maxima

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  • Posts: 15
Re: Elevated liver enzymes after Vosevi?
« 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.)





 




« Last Edit: June 29, 2019, 04:17:45 am by Maxima »

Offline Lynn K

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Re: Elevated liver enzymes after Vosevi?
« 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
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 Maxima

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  • Posts: 15
Re: Elevated liver enzymes after Vosevi?
« 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.



Offline Lynn K

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  • Member
  • Posts: 4,286
  • Get tested, get treated, get cured, fight Hep c!
Re: Elevated liver enzymes after Vosevi?
« 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.
« Last Edit: June 29, 2019, 05:24:34 pm by Lynn K »
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 Lynn K

  • Global Moderator
  • Member
  • Posts: 4,286
  • Get tested, get treated, get cured, fight Hep c!
Re: Elevated liver enzymes after Vosevi?
« 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.
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 Maxima

  • Member
  • Posts: 15
Re: Elevated liver enzymes after Vosevi?
« 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




 


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