chronic state of hepatitis from unknown reasons

[lonewolf92]

Hello,

I am facing liver inflammation from past 1 year. It started from an unknown illness last year.
My fibroscan score has reached 6.6 kpa that suggests f1 grade of fibrosis. I also feel pain in liver area and back pain.
I tested for several viral infections like Hep B, C, HIV, herpes  but none was reactive except CMV Igg.
I am confused as the doctors are saying that its due to NAFLD but i dont think my life style is that bad to get NAFLD.

Does anyone here have any relevant information on this ?

Thank you.

[flyinlynn]

I would believe your doctors.

[lonewolf92]

Hi, Thank you for the answer but I am not overweight nor does I consume lots of sugar.
I am wondering, How come it be NAFLD when it actually started after illness to me ?

[lonewolf92]

i am worried if it is due to some-other condition like autoimmune etc. how should i verify that ?

[flyinlynn]

How to determine is ask your doctor.

Sugar consumption is not related to NAFLD

Found this information

“While people who are overweight or obese are indeed at greater risk, thin people can also develop fatty liver disease, NASH and cirrhosis. This has come to be known as “lean NASH.” ... However, overall BMI is less important in determining risk for fatty liver disease than where the fat is located in the body.”

In other words you don’t have to be overweight to have fatty liver disease. You could be thin but have too much fat in your liver cells causing liver injury.

You should likely be seeing at least a gastroenterologist (Dr who specialized in all things gut related) or a hepatologist (liver specialist)

[flyinlynn]

When you say you are not overweight do you know your BMI?

[flyinlynn]

Fatty liver in lean patients: is it a different disease?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959355/

[lonewolf92]

HI, just found my BMI is around 25.5 so slightly overweight (oops).

I am consulting with Gastro doctor and given Silybon 140 mg and vit E capsules by him on this.

Unfortunately, all i remember is that i had mono like illness that appeared to me last month and after a few months my LFT was elevated. This is why I run for various tests that i doubt may be linked to this but all were negative except for CMV (which is supposed to be dormant virus).  Do you know if cmv virus trigger NAFLD ?

BTW, your story on the fight against hep-c is highly motivating.

Best wishes !

[flyinlynn]

Looked up Silybon which is more commonly called milk thistle seeds. It is an herbal treatment for liver inflammation with little evidence of effectiveness. I personally am not a believer in herbal supplements. They seem to me to be a waste of money especially as there isn’t really little to no clinical trial information to support its use.
No harm in trying but what you do need to do is eat a healthy diet and lose a little weight. Also, avoiding alcohol is very important as well as medications know to cause liver damage or take in moderation if required.

[flyinlynn]

Found some information about CMV and liver enzymes as well as Mono and liver enzymes.

Although mild elevations in liver enzymes can be seen in 40 to 80% of cases due to EBV-induced infectious mononucleosis (EM), clinical jaundice occures in 5 to 11% of cases. Liver test abnormality is seen in only symptomatic CMV infection. ... Unlike other herpes viruses, jaundice does not develop in CMV-induced hepatitis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578525/#__sec2title


Alkaline phosphatase, aspartate aminotransferase (AST), and bilirubin levels peak 5-14 days after onset, and gamma-glutamyltransferase (GGT) levels peak at 1-3 weeks after onset. Occasionally, GGT levels remain mildly elevated for as long as 12 months, but most liver function test results are normal within 3 months.

https://journals.lww.com/nursing/fulltext/2006/04000/can_mononucleosis_damage_the_liver_.25.aspx

Also this

Other causes of elevated liver enzymes may include:

Alcoholic hepatitis (severe liver inflammation caused by excessive alcohol consumption)
Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
Celiac disease (small intestine damage caused by gluten)
Cytomegalovirus (CMV) infection
Epstein-Barr virus
Hemochromatosis (too much iron stored in your body)
Liver cancer
Mononucleosis
Polymyositis (inflammatory disease that causes muscle weakness)
Sepsis (an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced)
Thyroid disorders
Toxic hepatitis (liver inflammation caused by drugs or toxins)
Wilson's disease (too much copper stored in your body)


https://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/causes/sym-20050830



So it does appear either condition could be related to elevated liver enzymes in some cases.

You are just only slightly above max normal range BMI at 25.5 so since you have other risk factors you might consider trying to get back below 25.0 BMI as that is something you can do to improve your health. It sounds as though elevated liver enzymes from mono should improve with time after the infection resolves.

Thanks for your kind words. I have been on my journey for a while since I originally learned I have hep c back in 1990. It has been a long road but I’m still walking my walk.

Keep working with your doctors and follow their recommendations.

Good luck

[lonewolf92]

Thank you for these details, I'll discuss them thoroughly with the doctors in the next visit.

I am glad and motivated to talk to a strong person like you.

Best wishes.

[copyman]

Hi hepcandme I'm also an old timer who went through treatment in a Telaprivar  trial back in 2007. There weren't many options back then.  I was clear a few years after so considered "cured" ( a word everyone was afraid of using back then). Hope all the old timers are doing well. Magnum, Mike, Jim, Dee, linda, debbi from NY, etc etc and so many more I can't remember all. This forum gave me so much info I feel it saved my life with finding out about all the new drugs, trials.  It was like a big family back then.
Came on the site a few years back and saw everything changed and said hello. Think I only heard back from one or two old timers.

Came back today because I tested positive for Covid and wanted more information from real people that had it.

Take care and Happy Holidays
"copyman"

[R Glass]

Hello Copyman, I only pass through here occasionally.  I also treated in 2007 successfully. Unfortunately, I had to go thru the dreaded Riba/ Int. Yes much has changed here. Trying to keep up was like reading a Marge. Almost all of us were suffering from "Riba Rage" and this was
the only place to go that understood what we were going through. M.H. was constantly threatening to shut us down if we didn't quit fighting. I moved on after they came out with new treatment. I knew very little about the new treatments and felt I had little to offer. I had Covid once but it was the  "easier" strand. I knew I had it before I tested positive. It was strange fee;ing. I had it for about a week, it took me almost a month to completely get over it. I