ALT

[iwillbeatthis]

I'm coming into week 23 (of 24) and my recent ALT was 15, down again a few points from last month.
Is it the lower the ALT the better? Does it indicate more healing when it goes lower?
How low did people's ALT go here when on tx and after tx?
Thanks,
Bree

[nygirl7]

Hector why can't you have root beer? I know that sounds like a silly question since I've been on here for so very long but I just can't think of why you can't.....it made me sad to know you want one and can't have one. You're such a great guy you deserve at least THAT waaaaaaaa.  

[iwillbeatthis]

I know about that, the alt ast can be normal with cirrhosis.
Hector I have followed you throughout my tx, you are incredible, your attitude is amazing, I really admire you.

I do of course watch everything, all pretty normal, since you brought up creatinine, mine has been in the high .6's and low 7's for a while, that's normal range but on low side, what does that mean, what is creatinine measuring?
Thanks,
Bree

[HectorSF]

"with advanced cirrhosis sometimes there are not enough live liver liver cells left to die and release enzymes". Mikesimon has a point there.
Yes, it might sound strange to some but there are some of us with both compensated and decompensated cirrhosis can have "normal" ALT/AST test results.

At my last blood test my ALT was 39 U/L. Within range. Should I celebrate with a nice cold root beer. Cheers all! .....Naw, don't think so. Besides having "normal" ALT results, my platelet count (60), bilirubin (4.7), albumin (2.9), ferritin (1229), creatinine (0.58), AFT (120) are wacked, never mind the fatigue, ascites, encephalopathy, enlarged spleen, bleeding and other nasties that go along with advanced cirrhosis. Hmmm...guess I better put that celebratory root beer back on ice for another day.

I would recommend during treatment keeping an eye on the PCR results. The viral load response to treatment is the key to beating HCV.

Your almost done! Way to go! SVR all the way!
Hectorsf

[Trinity4]

Ah yes indeed.  I was clueless. Vunderbar!!  

[mikesimon]

I had no idea!
Thank for enlightening me.

Mike

[Bali05]

I was extremely ALT concious before tx.
On tx PCR is what counts , the rest is a wild guessing game.

[mikesimon]

Yes people are different, but there are, in fact, established reference ranges and a lot of HCV patients were first diagnosed because their ALT was elevated or higher than the reference range.
That is not to say that an elevated ALT means that treatment is not working. But, given a choice, I would choose an ALT within the reference range and generally speaking the lower the better.
And, that is not to say that a low ALT is invariably a healthy sign because we know that with advanced cirrhosis sometimes there are not enough live liver liver cells left to die and release enzymes so in that case a low ALT can be a negative sign.

[Bali05]

normal ALTs are different from person to person.
Men usually have a higher ALT than women also.
The meds themselves can elevate ALTs in some people.

I can`t imagine how crazy it must have been in the days when tx success was
measured by ALTs alone.

My ALTs during tx have been flactuating within in normal range and I had ALTs in
normal range before tx with a viral load of 90k.
So I learned I can have the same ALT being very UND<2 as with 90k.

[FlGuy]

Conversely, above normal AST/ALT during treatment is not indicative of treatment un-success.

[iwillbeatthis]

thank you guys.
my AST is 39, I guess that is ok?
I can't believe February is here, the EOT.

[Jakied]

the lower Alt is, the better.  for sure.

[mikesimon]

It's a good sign. It shows that cell death is down which is something I always like to see. As lever cells die they release enzymes and ALT is the most specific liver enzyme. People may and frequently do argue about the significance of ALT levels during treatment.
In my opinion it is a very good sign.

Good luck,
Mike

[nygirl7]

Mine started at almost 300 and now after treatment are at about 10.

One time during treatment they went up a couple points after being down for a long time. I freaked out, rushed to the doctor for an emergency appt and he laughed at me. He was like Deb they go up and down dont sweat a ten point increase.......he was right.