Do I have acute Hepatitis C?

[jgag1234]

Hi all,

Would like to request your help interpreting my situation.

Last week my AST and ALT were found elevated at 89AST and 126 ALT. I tested becasue I was undergoing f/u routine serologies for HIV and Hepb/C after a high-risk exposure (unprotected sex with CSW -6 months ago)

My initial Hep B/ Hep C and HIV testing was done at 5 weeks post-exposure and then at 12 weeks.

My Hep serology Results below

Hep B Core Ab, IgM Negative
Hep B Surface Ab, Qual Negative
Hep B Surface Ag Negative
Hep C Antibody IA Negative
All Liver enzymes were normal

As above, these tests were repeted last week at 181 days (6 months) post exposure and they all remain negative including my HIV test. The only abnormality was my liver enzymes and my RUQ pain for the past 3 months. I drink lots of wine and take Aspirin and NAprosyn for back pain constantly.

How can I interprete these blood results with my elevated liver enzymes and pain?

Thank you in advance

[Idyllic]

Hep C Antibody IA Negative

Means there was no presence of the Hepatitis C Antibody which means you can feel confident that you are hepatitis C free.

[jgag1234]

SO how can I explain my new liver enzymes and the RUQ pain I am having? It is difficult to ignored my exposure despite of the testing

[can-do-man]

This is a Hepatitis C forum and you do not have Hep C, try educating yourself as you did not have a high risk exposure to begin with... As for explaining your high liver enzymes? Why not ask your doctor? From your post you have had plenty of chances......

[can-do-man]

I now see why...
----------------
H. Hunter Handsfield, M.D.

Mar 28, 2013

When you make an appointment, you should not request any specific tests.  Just tell your story and show your lab results to the doctor then follow his or her advice.

I have no other comments or advice, and will not have anything more to say about any other test results for HIV or anything else.  It is time to stop testing yourself for anything; to disregard the sexual exposure you are so obsessed with; and to stop relying on this or any other online resource for your health care.  We provide only general advice, not actual diagnosis or treatment recommendations.

http://www.medhelp.org/posts/HIV---Prevention/HepC-HIV-con-infection/show/1922272#post_8974704

[jgag1234]

Was under the impression this was a patient supporting web forum. Did not expect I would be judged for my insecurities or extreme anxieties including my lack of proper medical attention.

Thank you for taking the time to write can-do-man. Best luck to you

[willbb]

How can I interprete these blood results with my elevated liver enzymes and pain?
----------------

I think possibly your answer may be in your next sentence
------------------------------
I drink lots of wine and take Aspirin and NAprosyn for back pain constantly.


   Altho I am not a doctor...........

best...

Will

[can-do-man]

Sense I just copied what the doctor here at Medhelp had told you then maybe you should take it up with either him or Medhelp as those were his words not mine..........Best to you to.

[mzkity]

How does anyone take aspirin and an antinflammatories (sp) plus drink wine???  
Yes willbb sounds good.  Ha!! Lol!!

[jgag1234]

So if you are a cardiac pt- meaning you have heart disease and are taking aspririn for heart protection, you have to avoid wine?? NOT the CASE....
Obviously this is not the question here. The main question is how can one interprete the serology results posted in the context of the clinical picture presented here. Thx for your interest and great support !

[pooh55811]

"The only abnormality was my liver enzymes and my RUQ pain for the past 3 months. I drink lots of wine and take Aspirin and NAprosyn for back pain constantly.

How can I interprete these blood results with my elevated liver enzymes and pain? "
-------------------------------------------

Since your Hep panel is negative and has been for several months, you apparently do not have Hepatitis A, B, or C.

However, both and/or either wine and/or NSAIDS can cause the liver enzymes to become elevated. Combining them is a double whammy.

http://livertox.nih.gov/Ibuprofen.htm

http://www.livestrong.com/article/191457-nsaid-dangers-to-liver/

So your liver enzymes may be elevated from wine or NSAIDS or both. Of course, there are other reasons for having elevated liver enzymes so it is best to see your doctor and have your doc do some testing to determine the cause. In the meantime, it would probably be a good idea to stop drinking all wine (and also avoid any other alcohol, including beer).

In addition, Aspirin, NSAIDS, and/or alcohol (including wine) are all gastric irritants, and any one of them, by itself, can cause a gastric ulcer. Combine all three and you have a triple whammy.

Your pain may be from your ASA, NSAIDS, and wine intake but it should be from something else too, so it is best to see your doctor and have your doc do some testing to determine the cause. In the meantime, it would probably be a good idea to stop drinking all wine (and also avoid any other alcohol, including beer).

Best of luck.

[jgag1234]

Understand that, Thx. However your statement of " No, you dont have Hep C" has to be based on something correct?

[can-do-man]

Yes your tests results.........

[mzkity]

Ok it's been answered every way possible. Now---how do you mix wine and naprosyn with out the obvious results. Pooh detailed it. I think even a seasoned drinker would have trouble with that combo.

[hrsepwrguy]

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[can-do-man]

"My initial Hep B/ Hep C and HIV testing was done at 5 weeks post-exposure and then at 12 weeks.

My Hep serology Results below

Hep B Core Ab, IgM Negative
Hep B Surface Ab, Qual Negative
Hep B Surface Ag Negative
Hep C Antibody IA Negative
All Liver enzymes were normal

As above, these tests were repeted last week at 181 days (6 months) post exposure and they all remain negative including my HIV test."

Tested at least 3 times and all 3 times it came back Negative... What is so hard to understand there?

[FlGuy]

There is another possibility to consider and that is that all of the tests, except the enzymes,  were false negatives and that the OP has chronic HCV. Just sayin'

[can-do-man]

LOL

[jgag1234]

Thank you for your thoughtful response. Just for the record, I dont mix the wine with the pain meds :-0

Many other medical websites say that you can still test negative at 6 months post exposure and becasue elevated ALT you must have a HCV RNA test. This one is cooking as we speak- same with an medical appointment. I will let you know the RNA test results so we all can learn about my case + my doctor's thoughts. Thx

[hrsepwrguy]

Naprosyn

Warnings
Hepatic Effects

Borderline elevations of one or more liver tests may occur in up to 15% of patients taking NSAIDs including Naprosyn, EC-Naprosyn, ANAPROX, ANAPROX DS and Naprosyn Suspension. Hepatic abnormalities may be the result of hypersensitivity rather than direct toxicity. These laboratory abnormalities may progress, may remain essentially unchanged, or may be transient with continued therapy. The SGPT (ALT) test is probably the most sensitive indicator of liver dysfunction. Notable elevations of ALT or AST (approximately three or more times the upper limit of normal) have been reported in approximately 1% of patients in clinical trials with NSAIDs. In addition, rare cases of severe hepatic reactions, including jaundice and fatal fulminant hepatitis, liver necrosis and hepatic failure, some of them with fatal outcomes have been reported.

A patient with symptoms and/or signs suggesting liver dysfunction, or in whom an abnormal liver test has occurred, should be evaluated for evidence of the development of more severe hepatic reaction while on therapy with Naprosyn, EC-Naprosyn, ANAPROX, ANAPROX DS or Naprosyn Suspension.

If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (eg, eosinophilia, rash, etc.), Naprosyn, EC-Naprosyn, ANAPROX, ANAPROX DS or Naprosyn Suspension should be discontinued.

http://www.drugs.com/pro/naprosyn.html

[pooh55811]

"Just for the record, I dont mix the wine with the pain meds :-0 "
-----------------------------------------

You don't have to take them at the same time to cause gastric problems or liver problems.

ASA, NSAIDS, and wine all individually irritate the gastric lining. Or, put another way, any one of them is a gastric irritant. Taken together or separately, they still end up being gastric irritants and can cause ulcers. The gastric irritation from an aspirin or an NSAID does not stop the minute the pill is dissolved. And the gastric irritation from wine does not stop the minute one stops drinking wine either.

If a person puts a drop of acid on his arm, it burns and eats a little tiny crater in the skin. It eventually stops hurting but it is not healed and the little crater is still there. Then, if the person puts another drop of acid on the same spot, the crater gets bigger and/or deeper. If one keeps this up, that crater is eventually going to eat a hole right through the skin. Well, ASA is an acid. NSAID may as well be acid. And wine is acidic. They all act like acid eating away a little at a time at the gastric mucosa. They don't have to be there at the same time. One can be there at 8 am and 4 pm. Another can be there at 12 noon and 8 pm. And the other can be there at 6 pm and 10 pm.  Well, that is a steady stream of gastric irritants and the gastric mucosa is not healing up in between.

With the liver, those chemicals stay in the blood stream for a while. They don't disappear in any hour. Every time the chemicals go into the body, they affect the liver. The more that go into the body/blood stream, the more the liver is affected.

Try drinking no alcohol for a month. See if your liver enzymes decrease. You might be surprised at how much they decrease.

As for the ASA and NSAIDS, ask your doc about them. Maybe there is another treatment regimen that can be tried for your chronic back pain.

By the way, and I am not saying this is what is going on in your case, but it is a thought, gastric ulcers often manifest with back pain in addition to or instead of with stomach pain.  

There are many reason you could be having pain, both the back pain and your right upper quadrant pain. That is why you need a doctor to examine you and do testing so that the reason can be determined.

Your doc could also check you to see if you have autoimmune hepatitis.

http://digestive.niddk.nih.gov/ddiseases/pubs/autoimmunehep/