Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

Elevated Liver Enzymes - Ideas?

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vaguesbleues:
Hello everyone.  I have noticed in the past several months that my liver enzymes have been pretty elevated, and it seems to correspond to when I began taking Atripla about a year ago.  I've included my levels for the past year or so since starting on Atripla, as well as the two sets of results prior to starting on medication. 

11/15/2012:  Alkaline Phosphatase:  150 (normal is <140)
                  AST:  42  (normal is <40)
                  ALT:  96 (normal is <60)

8/1/2012:  Alkaline Phosphatase:  151
               AST:  34
               ALT:  70

1/31/2012:  Alkaline Phosphatase:  158
                AST:  35
                ALT:  79

10/25/2011:  Alkaline Phosphatase:  143
               AST:  33
               ALT:  76

9/2011:  Started Atripla

6/13/2011:  Alkaline Phosphatase:  125
               AST:  18
               ALT:  38

4/29/2011:  Alkaline Phosphatase:  121
               AST:  14
               ALT:  36

It's been concerning enough to my doctor that he ran a ton of extra tests prior to my last doctor visit, including:  Hepatitis C (negative), A ton of antibody tests including Anti-centromere, Anti-dsDNA, Anti-Jo1, Anti-RNP, Anti-Scl70, Anti-Sm, Anti-Ro, Anti-La (all negative), and a complete ultrasound of my abdominal areas (liver, gallbladder, pancreas, spleen, kidneys, vasculature...all came back normal).

Maybe seeing elevated liver enzymes (indicating that the liver is under some amount of distress and dumping them into my bloodstream) is somewhat normal when on antiretrovirals. But I was under the impression that issues with Kidneys were more common on the medications that I am currently on, but my creatine levels have been all normal. 

Would any of you have any potential suggestions for what is going on?  Or even suggestions for what could get my numbers a bit closer to the normal range?  As a side note, I am not a heavy drinker, having a glass or two of wine a week, if that. 

Any advice would be greatly appreciated.  Thanks!

newt:
These are close enough to statistical normal to be normal. Liver enzymes are very sensitive to lots of things, including exercise and food. 5 x normal limit on 2 tests is when to start worrying.

- matt

vaguesbleues:
Ahh thanks.  I was wondering why he was so adamant about testing for such things as hepatitis when I was under the impression that hepatitis would send those numbers skyrocketing.  Thanks for your reply!

Ann:

--- Quote from: vaguesbleues on November 27, 2012, 06:28:54 PM ---Ahh thanks.  I was wondering why he was so adamant about testing for such things as hepatitis when I was under the impression that hepatitis would send those numbers skyrocketing.  Thanks for your reply!

--- End quote ---

Anyone who is hiv positive should be periodically screened for hep B and C as a matter of course.

Also, you can have perfectly normal liver enzymes levels and also have hep C - I know because I did - and I did.

I'm not sure if it's the same with hep B -but I would imagine having normal enzymes levels is possible in a case of chronic (as opposed to acute aka very recent) hbv infection, depending on what other stress your liver is experiencing.

Pozitively Moving Forward:
My partner (poz 01/12) has had elevated liver enzymes for the past 3 years.  His numbers have been pretty consistent  AST mid-upper 40's and ALT high 90 to low 100.  His ID doc wanted to find out the cause before meds were prescribed.  He's had all the various tests done including liver biopsy in Oct.  Diagnosed as Non-Alcoholic Fatty Liver. 
ID doc told him to take 400mg. of Vitamin E daily and NO other supplements.  Expects numbers to be in normal range by December to start on meds.   Next appt is on the 6th.

Good luck.




       

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