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Author Topic: Elevated Liver Enzymes - Ideas?  (Read 1625 times)

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Offline vaguesbleues

  • Member
  • Posts: 93
Elevated Liver Enzymes - Ideas?
« on: November 19, 2012, 04:14:05 PM »
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!
03/10/2011 - Tested HIV negative
04/26/2011 - Inconclusive WB result
05/19/2011 - Confirmed HIV positive
                    VL < 50, T-Cell 747 (30%)
06/13/2011 - VL 345, T-Cell 841 (30%)
08/23/2011 - VL 50,100, T-Cell 1155 (19%) - CMV
09/18/2011 - Started Atripla!!
11/07/2011 - VL 489, T-Cell 881 (31%)
02/08/2012 - VL Undetectable!!, T-Cell 772 (34%)
08/08/2012 - VL UD, T-Cell 1070 (42%)
11/05/2012 - VL UD, T-Cell 1174 (35%)
03/18/2013 - VL UD, T-Cell 972 (28%)
10/04/2013 - VL UD, T-Cell 1025 (34%)

Offline newt

  • Member
  • Posts: 3,885
  • the one and original newt
Re: Elevated Liver Enzymes - Ideas?
« Reply #1 on: November 23, 2012, 04:10:58 PM »
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
"The object is to be a well patient, not a good patient"

Offline vaguesbleues

  • Member
  • Posts: 93
Re: Elevated Liver Enzymes - Ideas?
« Reply #2 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!
03/10/2011 - Tested HIV negative
04/26/2011 - Inconclusive WB result
05/19/2011 - Confirmed HIV positive
                    VL < 50, T-Cell 747 (30%)
06/13/2011 - VL 345, T-Cell 841 (30%)
08/23/2011 - VL 50,100, T-Cell 1155 (19%) - CMV
09/18/2011 - Started Atripla!!
11/07/2011 - VL 489, T-Cell 881 (31%)
02/08/2012 - VL Undetectable!!, T-Cell 772 (34%)
08/08/2012 - VL UD, T-Cell 1070 (42%)
11/05/2012 - VL UD, T-Cell 1174 (35%)
03/18/2013 - VL UD, T-Cell 972 (28%)
10/04/2013 - VL UD, T-Cell 1025 (34%)

Offline Ann

  • Administrator
  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Elevated Liver Enzymes - Ideas?
« Reply #3 on: November 27, 2012, 07:06:38 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!

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.
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

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HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Pozitively Moving Forward

  • Member
  • Posts: 14
Re: Elevated Liver Enzymes - Ideas?
« Reply #4 on: November 29, 2012, 03:12:36 PM »
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.




       
1/11/12 Test Positive HIV CD4 - 434 VL - 58K
2/8/12  CD4 316 VL- 62K (15%)
4/24/12 CD4 - 333 VL-33K (22.3%) 
5/8/12   CD4 - 419 VL - 124  (23.1%)
5/22/12 CD4 - 456 VL - 30  (24.5%)
6/19/12 CD4 - 593 VL - >20 (26.1%)
7/17/12 CD4 - 463 VL - >20 (28.1%)
8/14/12 CD4 - 476 VL - >20 (32.2%)

Offline tednlou2

  • Member
  • Posts: 4,981
Re: Elevated Liver Enzymes - Ideas?
« Reply #5 on: November 29, 2012, 04:56:31 PM »
Liver labs have always confused me.  My liver doc said many experts believe the range of normal needs to be adjusted down, back to where they were in the 90's, according to him.  He said 30 was the upper limit of normal back then.  I was surprised when he told me my liver labs were elevated, even though they were within the normal range. 

But, here's something interesting.  My labs were often at the high end of normal.  They switched labs to LabCorp and my numbers are at the very low end of normal.  This has to do with the lab.  I've had no change in meds and never had hepatitis.  They were always at the high end and then with new lab at the low.  So, it makes me think there is wiggle room, and as Newt pointed out usually nothing to worry about, unless really high. 

 


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