Diplomat on Twinvir

This topic has 22 replies, 12 voices, and was last updated 8 years, 7 months ago by fretboard.

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21 April 2016 at 5:16 pm #15961
diplomat
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- Novice
@diplomat
Ok, so here’s what’s happened since starting Twinvir treatment:

30/12/2015
VL 1980000
AST 257
ALT 257

20/01/2016 – commenced treatment

12/04/2016 – completed treatment
VL undetected
AST 87.3
ALT 99.4
GGT 75

I’m treatment experienced (interferon 200 and it took three months for the virus to emerge again. LFTs still high (but they were very high to begin with). I will update in two months.
22 April 2016 at 4:31 am #15985
Dr James
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@fixhepc
Hello Diplomat,

Those LFTs are unusually high for EOT. I would wonder if you have something else going on as well with chronic Hep B being pretty high on the list.

Have you had HepB surface antigen, HepB core antibody, HepB surface antibody done?

You should also have an alpha feto protein (AFP)

If you don’t have Hep B I would be looking for haemochromatosis next – iron studies and if elevated look for the genetic markers.

Your LFTs should be much better than they are – please don’t ignore this. There is something else to find.

YMMV
22 April 2016 at 5:25 am #15989
fretboard
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@fretboard
”James-Freeman-facebook” wrote:

Your LFTs should be much better than they are – please don’t ignore this. There is something else to find.

Gotta agree with the Doc on this, your ALT and your AST are higher than normal ranges. Are you taking anything else that would affect your LFT’s like antihistamines or any other drugs, even otc drugs? Other than that, big time congrats on your UND!!!

G1a dx’d in 1992, Biopsy F2 VL 8mill +. Tried tx with Interferon/Riba, back in 2008 didn’t last long it felt horribly ugly!! I stopped tx, after 5 weeks!!
Started tx 6/1/16 with Harvoni.
12 Month Labs= UND
22 April 2016 at 6:28 am #15993
diplomat
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@diplomat
Thank you, Dr Freeman and Fretboard

I definitely do not have Hep B but in the early 90s blisters developed on the back of my hands that doctors told me was symptomatic of Porphyria Cutanea Tarda. The skin on my hands and fingers at that time was so fragile that a mere scrape would cause it to lift and peel as easily as a film of glad wrap. I was advised to not spend much time in the sun and to reduce alcohol intake, and I followed the suggestions. I haven’t had the blisters or fragile skin for 20 years now, and while I have a drink or two per week, my energy levels are high and I’m physically very active and spend a moderate amount of time in sunlight. I have not taken drugs in 20 years and have never taken medication regularly and only rarely receive a medical prescription.

If my memory serves me well, PCT can be inherited or acquired. I’m not to sure what the case is with me. Should I pursue this? I am active and fit – I evenran a marathon while on my Twinvir treatment!

Thank you once again for your time and concern.
22 April 2016 at 6:57 am #15999
Dr James
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@fixhepc
Hi Diplomat,

Your LFTs suggest something else is going on. If it’s not HBV we (as in some doctor or other) needs to work their way down the list of likely suspects. Checking your iron studies would be high on my list of next things to do.

It’s a big list but please have a look at: http://www.medicinenet.com/liver_blood_tests/page7.htm and the following pages. One (or more) of those is probably at root cause.

The key point is that your ALT/AST have not normalised so there MUST be something else driving it (now that we know the HCV is no longer the issue).

YMMV
22 April 2016 at 9:32 am #16003
fretboard
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@fretboard
Yep, something isn’t right. I don’t know what it could be but it could be related to drinking alcohol, maybe. I suggest you stop drinking at least a week before you take your next blood test and definitely talk to your doctor about your levels being high as I am definitely not a doctor and not even a nurse. lol Your GGT is high as well but I don’t know anything about that. Here’s a pic and on the far right are the normal ranges, this is one of my blood tests from years ago. Hope the pic works, if it don’t work I’ll just put something else up. good luck!!

G1a dx’d in 1992, Biopsy F2 VL 8mill +. Tried tx with Interferon/Riba, back in 2008 didn’t last long it felt horribly ugly!! I stopped tx, after 5 weeks!!
Started tx 6/1/16 with Harvoni.
12 Month Labs= UND
22 April 2016 at 9:42 am #16004
Dr James
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@fixhepc
Alcohol usually causes isolated GGT elevation. It’s not that it can’t cause other enzymes to go up but more commonly it’s the GGT which is out of range. If you look at HCV when you remove the liver damaging insult the ALT is the first to fall (it only hangs round for a short time) – the AST and GGT follow it down, but are slower. The LDH and ALP are slowest.

YMMV
22 April 2016 at 8:19 pm #16036
fretboard
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@fretboard
”James-Freeman-facebook” wrote:

Alcohol usually causes isolated GGT elevation. It’s not that it can’t cause other enzymes to go up but more commonly it’s the GGT which is out of range. If you look at HCV when you remove the liver damaging insult the ALT is the first to fall (it only hangs round for a short time) – the AST and GGT follow it down, but are slower. The LDH and ALP are slowest.

Appreciate your knowledge Doc!! Super!!

G1a dx’d in 1992, Biopsy F2 VL 8mill +. Tried tx with Interferon/Riba, back in 2008 didn’t last long it felt horribly ugly!! I stopped tx, after 5 weeks!!
Started tx 6/1/16 with Harvoni.
12 Month Labs= UND
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