POZ Community Forums
Main Forums => Living With HIV => Topic started by: bmancanfly on December 01, 2009, 05:54:02 pm
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I just got my most recent labs back from a 11/6/09 blood draw. Unfortunately, my liver enzymes seem to be suddenly way out of whack, the AST was 41 and the ALT was 72. They have never been high before. And I don't know whether to be concerned or not.
I can't imajine why the sudden change. I did drink quite a bit on Halloween. Could that still have an effect on my liver enzymes 6 days later. Even so, it's quite a dramatic change from all previous test, AST usually in the 20's and ALT usually in the 20's or 30's.
I've been on Viramune and Truvada for almost two years without incident - up until now.
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If this is the first time they have been this high, I wouldn't sweat it until a repeat is done. It really isn't all that unusual for some lab results to go "out of range" on a draw and then go back to normal. Single results are rarely meaningful... you should get them repeated and see if they remain elevated. If you doctor was concerned he/she would have had them repeated right away is my guess.
When I had Hep A, both my AST and ALT were over 1,000 -- 3 weeks later -- they were normal.
Mike
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thanks bocker for your reply.
After finishing my 30 second quarterly meeting with my doc I feel more confused than I was before. He throughs out a few scary buzz words like hepatitus and mumbles something about Viramune and liver toxicity but never really gives me any info to go on - then he's on to the next patient on the assembly line.
All I remember from what he said was that we should do my next labs earlier than normal, six weeks out instead of 3 months as usual. But reviewing the blood work requisition I don't see where he even requested a hepatitus test. So why throw that out there as an option if you're not even gonna test for it?
I do remember him saying that they are seeing "a lot" of hep C lately, whatever that means. And I just read the whole thread about safe sex with other pozzies and the consensus seems to be that Hep C is most likely spread from drug use - which I don't do and he knows that.
Bocker, your liver enzyme numbers were much higher than mine are when you had hep A. Should I even be concerned about hep C with my numbers?
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As bocker stated, I think you should not get too worked up by one reading. I once had a spike in my liver panel and then it went back to normal and has stayed there.
Have you been vaccinated for Hep A and Hep B?
As far as Hep C it doesn't hurt to be tested for it even if chances are you don't have it based on your risk factors.
In the meantime, you should consider drinking a cup or two of coffee a day. A couple of very reputable studies have found it helps liver function and if by any chance they are wrong, it can't hurt to have one or two cups (max) every day.
LINK:
http://forums.poz.com/index.php?topic=29621.0
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bman, you can have normal liver enzyme levels even when you have hep C. I often (but not always) did when I still had hep C.
Anyone who has hiv should be screened for both hep C and hep B. Hep B can be vaccinated against (but hep C can't) and if you don't already have a natural immunity (from having it previously) you should get the vaccine. Hep C should be screened for periodically. You should speak to your doctor about this and don't let the subject drop until you get some satisfactory answers out of him. You're not a number on an assembly line, you're a human being and he's being paid to look after you. Make sure he realises that.
Ann
edited for a stooopid typo
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Thanks for your replys Ann and Inch.
I did have a Hep B vaccination but they forgot to follow up with the test to see if it took. I spoke with the nurse at my docs office (the Great and Powerful Oz couldn't be reach directly) and he will order it for my next labs as well as the Hep C test. I don't know why they don't do this without my insistance, esp. the Hep B follow up. Seems like it should be standard practice.
Oh, and I hate the taste and smell of coffee so that's not an option - but thanks for the suggestion
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I believe AST under 50 is considered normal. I just had this question yesterday. My numbers were always in the normal range---30's to 45. My AST was 75 on this last check. I'm not sure why. I did fast for cholesterol on this blood-work. I took Tylenol on empty stomach before blood-work. Who knows.
If your AST is under 50, I don't think you have anything to worry about. Does the lab you use have different guidelines for normal?
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I just looked at the normal ranges on my blood-work from my lab. AST is 10-50 and ALT is 20-70.
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Different labs appear to use different normal ranges. My lab, Quest, uses normal ranges of 10-35 for AST and 9-60 for ALT. There appears to be quite a significant difference amongst labs. This is confounding and confusing.
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It's one of the curses of the internet -- you get info that seems pertinent to you, but is not.
You should focus on reference ranges provided by the lab that performed your tests. It simply doesn't matter what a different lab's ranges are -- Labs SHOULD come up with their ranges based on the population they serve. Of course, many large labs use the same ranges for all their sites and many small labs take reference ranges from these larger labs. So, while labs don't always do what they SHOULD, you should simply rely on the reference range provided by your lab.
Differences in the ranges can also be due to the methodolgy used by a lab in performing the test.
Mike