AST/ALT Indicative of SVR at EOT+8 weeks?

[mike716]

Hi, all.

I hope everyone is being treated with the new DAAs and getting cured. It's a new world out there.

I finished 12 weeks of Tx with Sovaldi + Olysio at the end of January. I'm slated for a VL at the end of April (EOT+12), but I am a nervous wreck from waiting. Also, I have to go back to Buenos Aires for the VL at my hospital there as the test is prohibitively expensive in New York if, like me, you don't have U.S. insurance. And if I'm not cured I'll have to turn right around and come back to New York again. Kind of a catch-22 situation.

But I can get a blood test including hepatic enzymes quite inexpensively here in NYC and I was thinking that maybe the results would tell me if I'm cured. Surely if I've relapsed the AST & ALT would be back up again, no? (They were around 100 before Tx and then down to 21 and 10, respectively, at week 8 on the meds.)

Anybody here have experience with this? Help will be much appreciated.

Cheers.

Mike

[Ekkiemom]

Hiya HepC.
gotta go with your statement...I believe that those of us absolutely know the risk of not following Tx protocol.
And in my opinion, I tend to believe that those who have not decided to treat are either not informed enough to know there is a cure,sadly or are just not ready to commit, and on the other side of that when you finally come full circle and decide to treat you know the small side effect risks but are willing to treat and will forgo this in order to cure no matter what...in for the long haul.
Choosing a healthy does help the  liver to not work so hard, like abstaining from red meat especially loaded with growth hormones, not drinking is a gimme, IF you are a serious treater....
It is the Tx combo type and genotype that primarily predicts the outcome.  Yes it may be harder in some cases than others, as we have seen on this very forum which is truly unfortunate. But they too will clear..
And as I said its my opinion, and some common sense, that's it

Wishing the community well
Peace
Deb

[mike716]

Hi, Hector. How the heck are ya? It's been a while. Thanks for your posts and the helpful info. I'm gonna do the blood test for AST/ALT.

Congratulations on clearing the virus at last!!! I am so happy for you.

I hope you will still be around in the forum. There aren't many of us old-timers left.

Cheers.

Michael

[mike716]

Thanks for your encouraging words. I will do the AST/ALT test.

M.

[HectorSF]

Your doctor makes a good point and if you don't have health insurance, periodic viral load tests during treatment tell little. Viral test are not as important as they used to be. Which is why the hepatitis C guidelines only recommends VL testing before treatment, then at week 4 and only at week 6 or 8 if still undetectable. These tests are used to test for patient compliance they tell nothing about the odds of SVR. SVR rates are based on a patient's profile BEFORE treatment and the treatment prescribed - genotype and subtype for some, treatment experienced or not, cirrhosis or not these are the biggest factor for success. What happens with the viral load is irrelevant unless you are not taking the treatment meds consistently.

All people who treat with a DAA based treatment become undetectable on treatment and stay that way as long as they remain treating. No non-responders, viral breakthroughs, etc. like in the good "old days". All people that fail treatment do so by relapsing after finishing/stopping the treatment meds. By the way it doesn't matter when you become undetectable, week 1 or week 8 SRV rates are the same.

By now if you relapsed by week 4 I would imagine your ALT and AST would be going higher assuming you had raised levels prior to treating as can-do pointed out.

ALT and AST lab tests is a cheap way to have peace of mind. If they are still low the odds are huge you will be cured. Of course you must be prepared for bad news if by some small chance you have relapsed. But even then, why wait around for weeks not knowing? I personally would rather know one way or another. I know everyone may not.

I am okay. Cured of hep C but still dealing with post liver transplantation issues now 15 months since my transplant. I am the co-Community Leader for the Cirrhosis forum so that is where I am on MedHelp pretty much.

Take care.
Hector

[Livelife777]

Hi Mike.   I'm going to approach it from a different angle which should also give you some thoughts to ponder.
I was one of the first participants  to start Sovaldi  (other then the clinical trial group) once it hit the shelves.   Because of that my Bloodwork was closely watched once the treatment was started.  Two weeks after starting Sovaldi my AST/ALT dropped 40-50 points right outta the gate.  With that correlation in mind along with the post #s it would appear that these 2 liver functions would surely be indicative of a relapse.  Therefore as mentioned even further verification that a low # would be cause for celebration.
I go along with the pack.   Ease your stress and get those values.
Personally, I think you've got it in the bag!
......Kim

[mike716]

Good luck with that transplant, Hector. 15 months in, sounds like it's gonna work for you.