Liver Enzymes Did Not Elevate For 4 Decades

This topic has 7 replies, 4 voices, and was last updated 4 years, 9 months ago by Dr James.

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12 April 2018 at 5:00 pm #27814
Cristine123
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- Treatment Warrior
@cristine123
Wondering why my liver enzymes did not escalate for so many years after probable contraction of HepC. Each year for the past 15 years I had a liver panel done; everything fine, until 6 months ago. But probably got the virus in mid 70s. Is this even possible?

Probably had HCV since mid-1970s, Diagnosed HCV 2/2018, ALT:124 AST:83, GT:1b, Liver Ultrasound: Normal, Fibrosure: 0.68 or high end of F3, VL: 13,896,061, Started tx 4/9/18 w/Harvoni for 12 weeks. Scared but committed
12 April 2018 at 9:16 pm #27818
Dr James
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- Guardian Angel
@fixhepc
Hello Christine,

Yes it is possible. Hep C seems content to do very little for years then the wheels fall off.

The liver enzymes we measure are actually part of the “guts” of the liver cells – when these cells die we see the liver enzymes released and can measure them in the blood.

One way the body normal deals with viruses is by killing the cells that contain the virus. In some patients they have a robust response and the disease is cured, in others the response is not enough to cure, but enough to cause ongoing damage.

Some patients, often with very high viral loads just allow the virus to do its thing and, as a result, don’t have much happen for ages.

When we look at the patient demographics we can see lots of people in their 40s 50s and 60s but very few who make it past 70 – this is because Hep C tends to chop the last 10 years or so off the expected ~80 years of age average when we tend to expire of natural causes.

YMMV
13 April 2018 at 6:16 am #27821
Cristine123
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@cristine123
Thank you, Doc, for the info. ❤️

Probably had HCV since mid-1970s, Diagnosed HCV 2/2018, ALT:124 AST:83, GT:1b, Liver Ultrasound: Normal, Fibrosure: 0.68 or high end of F3, VL: 13,896,061, Started tx 4/9/18 w/Harvoni for 12 weeks. Scared but committed
14 April 2018 at 2:41 am #27825
Ariel
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@ariel
”DrJames” wrote:

When we look at the patient demographics we can see lots of people in their 40s 50s and 60s but very few who make it past 70 – this is because Hep C tends to chop the last 10 years or so off the expected ~80 years of age average when we tend to expire of natural causes.

Hi Doc
Are these stats related to any person treated or not treated who has lived with HCV?

If my mean life expectancy from all people who have been infected by HCV is 70 then I better change a lot of things!

I’m in my fifties and cured of HCV via DAAs and had hoped that would make my life expectancy in range with all people with a healthy lifestyle. Could you please clarify the precise cohort of the quoted stat? I’m sure a lot of people would be interested to know!

Thanks.
Ariel
14 April 2018 at 10:11 am #27827
Dr James
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@fixhepc
Hello Ariel,

People with SVR are likely to die at the usual time ~80 of other causes.

People without SVR are likely to die earlier.

So what you can see here is that the 5 year mortality rate (chances of dying in the next 5 years) for people with current HCV is much higher than those who have SVR.

YMMV
16 April 2018 at 12:09 pm #27842
Ariel
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@ariel
Thank you Doc
29 December 2019 at 6:55 am #29649
joy2world
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@joy2world
I know this is a very old topic, but my liver enzymes are perfect. Absolutely perfect. I’ve had this virus for 15 years at the very minimum, with a viral load of over 3 million.

The only indication that I may possibly have Hep c was during routine labs where I had SLIGHTLY elevated AST levels…. (42 where the normal range was 40) Which prompted me to take the antibody test, which in turn showed that I had positive HCV antibodies.

5 years later, my liver enzymes are perfectly normal range. No indication of the virus. Yet I have confirmed the virus with a viral load of over 3 million.

Liver function tests perfect, prothrombin time normal, platelets normal… just absolutely bizarre. It is possible. I’m living proof.
30 December 2019 at 12:56 am #29652
Dr James
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@fixhepc
Yes it is definitely possible to have normal liver enzymes and have Hep C.

YMMV
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