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TOPIC: Liver Enzymes Did Not Elevate For 4 Decades

Liver Enzymes Did Not Elevate For 4 Decades 1 year 4 months ago #26261

  • Cristine123
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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
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Liver Enzymes Did Not Elevate For 4 Decades 1 year 4 months ago #26265

  • DrJames
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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
Last Edit: 1 year 4 months ago by DrJames.
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Liver Enzymes Did Not Elevate For 4 Decades 1 year 4 months ago #26268

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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
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Liver Enzymes Did Not Elevate For 4 Decades 1 year 4 months ago #26273

  • Ariel
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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
Gen 1a
Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas.
pre sof/led VL 240,000 Fibsc F0
Day 25 <30
Day 32 UND
Week 10 UND
EOT UND ALT11AST17GGT19
SVR4 UND ALT10 AST16 GGT13
SVR8 UND ALT <9 AST16 GGT15
SVR12 UND ALT14 AST19 GGT12 Bili 5
EOT +18 ALT13 AST20 GGT9 Bili 5
EOT +21 ALT11AST15
Cured SVR12
Dysplasia Adenomas RemvdAug '16
SVR24 UND ALT11AST16
ColonoscopyClear Nov17
LumpectomyClear ‘18
LithotripsyCytoscopyBiopsy 4/18
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Liver Enzymes Did Not Elevate For 4 Decades 1 year 4 months ago #26274

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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
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Liver Enzymes Did Not Elevate For 4 Decades 1 year 4 months ago #26289

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Thank you Doc
Gen 1a
Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas.
pre sof/led VL 240,000 Fibsc F0
Day 25 <30
Day 32 UND
Week 10 UND
EOT UND ALT11AST17GGT19
SVR4 UND ALT10 AST16 GGT13
SVR8 UND ALT <9 AST16 GGT15
SVR12 UND ALT14 AST19 GGT12 Bili 5
EOT +18 ALT13 AST20 GGT9 Bili 5
EOT +21 ALT11AST15
Cured SVR12
Dysplasia Adenomas RemvdAug '16
SVR24 UND ALT11AST16
ColonoscopyClear Nov17
LumpectomyClear ‘18
LithotripsyCytoscopyBiopsy 4/18
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