Hep C Discussion Forum

Hey John,

I'm curious about your fibroscan score and your previous results. You stated your last registered an 18, is that correct? Cirrhosis (F4) begins at 12.5. If you are cirrhotic, you need to know for sure. There are guidelines established for continued monitoring the fibrosis stage and the increased potential for HCC development. Your hepatologist will be able to inform you of this if you aren't already on top of it. All of us high flying fibrotics need to keep a watch on it, just for safety's sake. Standard guidelines indicate 6 month ultrasounds. I'm adding a graphic of the current fibroscan scoring system.

Hi John,

So, from what I can piece together you must be more than EOT+24 weeks now, and that you went UND early (by week 2? of your 24 weeks of your re-treatment with harvoni and riba)!

Big congrats!!!, well deserved, after your prior unsuccesful attempt, and then having to do the long re-treatment with riba!

Hard work, but you did so well! You got that golden und!!

You labs are a "bit" of curiousity, and tig is right, to keep discussing them with your doc for his feedback. You are on their follow-up radar now, so it should not be hard to keep tabs on all going forward.

I won't be able to shed any light on why you have (or have had) some flucuations, but, you ARE und, you have no other major oddities going on?, and the bloods are NOT wildly fluctuating or increasing in a dramatic fashion, so then, it is just wise for you and your doc to keep watching and conversing about them just for your own piece of mind. (I know, I too would be wanting some kind of explanation from my doc, for any increase in my labs, even if they were small and he just said, forget about it/don't sweat it, just so i could rest easier about it). There are other organs and systems that all work with your liver that may affect your LFT labs, gallbladder (for one) comes to mind. So, it is very hard to guess into what any small increase may mean. 

Your doc should be able to rule out any other conditions you might have had in the past still affecting you, or even conditions you may currently have, or are being treated for, that could account for slight rises in your ALT or other LFT's ... for instance, have you been given or have you been taking any presciption meds for some other condition you are being treated for?? Some prescription meds too, might "possibly" cause some minor flucs in your labs. 

Just to keep us confused (it seems), internationally, I have found quite a few dif "reference ranges" of what dif labs and dif countries consider "normal" for ALT's and other bloods. I have read all these dif ref. ranges for:

ALT ... 3 to 36 U/L, 7 to 55, 7 to 56, 17 to 63 (as Tig mentioned, the latest revision adopted, now shows at  29 to 33 - for men) 

AST ... 0 to 35, 18 to 40, 8 to 48

ALP ... 35 to 100, 45 to 118, 36 to 126, 38 to 126

Brother!

Until otherwise stated by your doc, or by your lab, go by the ref ranges your lab uses:

ALT ...  17 to 63, AST high normal limit is 35, ALP  high normal limit is 125

I was actually interested in the little lab blip you had early in your treatment, must have been in the first few weeks, maybe when your VL was crashing to und?, where your first ALP was only noted at 24?, but then your ALP actually increased, up to 163 and 154 and then nicely/ slowly came down and never increased upward again. Your bili was up a teeny bit too, for a wee while. That was interesting to me! But then everyone knows ... I'm weird, what catches my attention, and that i get interested in many things that end up not being of any grand consequence or significance!!!!

I don't think you have anything to worry about (now that your have so well proven yourself cured of HCV), but, wise to keep tabs on all things just for all-round reassurance.

Tig was asking about your F level, you said you were "3 - 4". Did you mean you were deemed to be F3 or 4 by means of a "Fibroscan", or by biopsy, or by what mode of measurement?? Just wondering how fibrotic/cirrhotic you are and how they decided that.

Congrats again, don't fret, just keep checking, keep on top of things and keep taking good care of yourself, just like you are doing.  C.

Greetings,

Hard to say what your normal numbers would be. The 31 you mentioned if while on Harvoni I believe the numbers go down during treatment. Mine did and then settled higher after EOT. 51 is still within the normal range.

JimmyK

Hey John,

Good to hear you're doing well. I think the ALT is one of the most telling liver tests. It will indicate whether there is any inflammatory processes occuring. Without going back and looking through your posts, can you tell me what your most recent fibrosis stage was? Those with higher levels of fibrosis will often have fluctuations in their enzymes and platelets. An ever increasing set of enzymes is cause for attention. Killing the beast does wonders for turning the entire inflammatory process around and allows the healing to begin. None of these improvements happens overnight, but steady progress is what we strive to achieve!