What Do Elevated Liver Enzymes Indicate?

Posted on Sat, 25 Oct 2014

Question: my wife is 34 years old and she is HCV patient, we came to know recently about it
her viral load 477000 ml
log value:- 5.68

please comment on this Liver fuction test report
http://scr.hu/33n0/la7ko
it says most of things are high
so what does that indicate
we had done her ultra sound , and doctor said her liver is fine

Answered by Dr. Dr.P.Ratnakar Kini (28 minutes later)

Brief Answer:
Type of Genotype to be known

Detailed Answer:
Hi,
I went through the liver function test report.
The transaminases SGOT and SGPT are high. The bilirubin is not significantly high.
This indicates that there is some degree of damage to the liver cells which most probably is due to hepatitis C infection.

Her viral load is also high.
She needs treatment.
Before starting the treatment the HCV genotype has to be ascertained. The duration of the treatment and the outcome depends on the genotype.
The conventional treatment is with Inj Pegylated Interferon once a week and C.Ribavirin everyday.
But recently the medication Sofusbuvir has been approved by the FDA for treating HCV and it is showing promising results. You can discuss with your gastroenterologist about the genotype and the medications.

HCV over a period of time can cause liver cirrhosis and cancer. Hence she has to be on regular follow up. Ultrasound scan of the abdomen and serum alpha fetoprotein tests are to be done every 6 months.

She also needs to get vaccinated against hepatitis A and B.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr.P.Ratnakar Kini (25 minutes later)

geonotype report is going to come next week

in my country currently sovaldi is going to come next year

so can she wait for 6 months or 1 year

or she should start treatment now ?

Answered by Dr. Dr.P.Ratnakar Kini (7 minutes later)

Brief Answer:
Get a Fibroscan

Detailed Answer:
Hi,
Till now her liver is not showing any signs of cirrhosis or cancer.
I would advise her to get a fibroscan done which will show any early changes of cirrhosis.
If fibroscan shows normal liver, then she can wait till next year to get prescription of Sovaldi.

Meanwhile you can also get the other pending test done - serum alpha fetoprotein.
Also get her vaccinated against Hepatitis A and B as mentioned earlier.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr.P.Ratnakar Kini (40 minutes later)

we have done ultrasound of liver. so still fibroscan is required ?

which other test are required other than serum alpha fetoprotein.
so we can do it together all at once

Answered by Dr. Dr.P.Ratnakar Kini (2 minutes later)

Brief Answer:
Fibroscan and Serum AFP

Detailed Answer:
Hi,
Fibroscan is a special type of ultrasound scan.
Discuss with your doctor whether the scan done was a simple ultrasound scan or a fibroscan. If not done already, get it done.

For the time being only do - fibroscan and Serum AFP.

Let me know if I can assist you further.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr.P.Ratnakar Kini (17 minutes later)

i checked doctor Prescription and XXXXXXX

it says ULTRASOUND ABDOMEN & PELVIS so it fibroscan ?

Answered by Dr. Dr.P.Ratnakar Kini (2 minutes later)

Brief Answer:
No it is not fibroscan

Detailed Answer:
Hi,
No it is not fibroscan.
So get it done.

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Above answer was peer-reviewed by : Dr. Ashwin Bhandari