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Have Fatty Liver And Hbp. Test Showed Elevated ALT Level. How To Control This Level?

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Posted on Sat, 9 Mar 2013
Question: Jaundice in 2002
Sugar at125-130 fasting and 135-145 random
ANTIBODY TOTAL (HCV AB TOTAL) 1.34 s/co
SGPT (ALT) 74 U/L
SGOT (AST) 35 U/L
CREATININE (ENZYMATIC) 0.9 mg/dL
HEPATITIS B SURFACE ANTIGEN QUALITATIVE (HBS AG QUALI) 0.14 s/co
URIC ACID (SERUM) 5.79 mg/dL
GLYCOSYLATED HEMOGLOBIN. 6.0000 %
Fatty liver as per ultrasound
Blood pressure slightly high

How can I bring ALT to normal range? Is it possible with diet?
What is probability of Hep c in PCR TEST to be positive as doctor sent my blood for PCR now?
Based in current results what you would say ?
doctor
Answered by Dr. Abhijit Deshmukh (3 hours later)
Hi XXXXXXX,
Thank you for writing to us.
We'll need to know what were the cut off levels of your anti HCV, and HBsAg levels to interpret whether these results are positive or negative. It looks like you have mild hepatitis.
If your doctor has asked for HCV PCR, it is likely that it is positive. Well in that case, we need to know that report. If anti HCV is positive, it is likely that PCR will be positive.
Also you have impaired glucose tolerance and fatty liver on USG which could be either Non alcoholic fatty liver or HCV related. It is worthwhile to get a lipid profile also done.
You need to reduce weight if you are over weight and be on a low carbohydrate diet to normalize sugars.
If your HCV PCR is positive then you will need a genotype and the treatment for the same with interferon.
This will help to normalize ALT levels.
Hope this answers your query.
Please let me know if there are any further queries.
Wish you a speedy recovery.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Abhijit Deshmukh (3 hours later)
Many Thanks Dr. XXXXXXX

What is anti HCV, and HBsAg (Anti HCV is different than HCV Antibody)

Doctor gave me following medicines
LEGALON TAB 70MG.
URSOFALK 250MG CAP 50'S

I have done Lipid Profile and CBC also and I have results. I will details below all as I don't know which one is relevant:

WBC 9.3 (10`3/UL)
NE% 51.7
LY% 32.0
MO% 7.3
EO% 8.5
BA% 0.4
NE# 4.8
LY# 3.0
MO# 0.7
EO# 0.8
BA# 0
RBC 5.36 (10`6/uL)
HGB 15.6 g/dL
HCT 46.3%
MCV 86.3 fL
MCH 29 pg
MCHC 33.7 g/dL
RDW 12.6 %
PLATELET COUNT 205 (10`3/uL)
MPV 8.7 fL

HBS AG QUALI 0.14 S/CO (NON REACTIVE)

CHOLESTROL 209 mg/dL
Triglycerides 188 mg/dL
UHDL 35 mg/dL
LDL 127 mg/dL

QUESTIONS
1. Based on above, what is probability that my PCR result will be positive
2. Can diet or any food reduce results that are out of range
3. How long it takes to recover if I take medicine for HEP C (if I am diagnosed +ve). Any idea about cost of medicines.
4. Can I work while taking medicines or these have very high side effects?
5. After taking medicines for Hep C (if I am +ve) and I am cured, will I still carry risk to myself and others? or in medical terminology I will still be Hep C patient?
6. My PCR result will come after 2-3 weeks (from Germany). Do you think any medicine can reduce +ve risk during this period

Many thanks and I am really grateful to you
doctor
Answered by Dr. Abhijit Deshmukh (2 hours later)
Hi XXXXXXX,
Thank you for writing back. I really appreciate your detailed message.
Well from the above reports its clear you do not have hepatitis B infection.
Anti HCV antibodies and HCV antibodies are same but still it is not very clear only on the basis of titre of HCV whether the antibodies are positive in your report.
1 If your anti HCV antibodies are positive (detectable ), then there is a very high likelihood that your PCR will be positive
2 . You need to stop alcohol (if you take any). There is no diet to alter it
3. Well, treatment depends on your genotype and may vary from 6 months to an year. Virus may become undetectable in 3 months but this response may vary with multiple factors and is difficult to predict. Cost in India varies between 2 - 3 lakhs rupees but not sure in other countries.
4.Yes you can work. Side effects are usually fever, body ache and malaise in some patients. Some times reduced hemoglobin, WBC count or platelets can occur
5. This will depend on treatment response and you will have to be under followup forever. Yes virus can come back any time and you may be anti HCV antibody positive
6 No
hope this answers your queries
wish you a speedy recovery...
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
Dr.
Dr. Abhijit Deshmukh

Gastroenterologist

Practicing since :2001

Answered : 597 Questions

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Have Fatty Liver And Hbp. Test Showed Elevated ALT Level. How To Control This Level?

Hi XXXXXXX,
Thank you for writing to us.
We'll need to know what were the cut off levels of your anti HCV, and HBsAg levels to interpret whether these results are positive or negative. It looks like you have mild hepatitis.
If your doctor has asked for HCV PCR, it is likely that it is positive. Well in that case, we need to know that report. If anti HCV is positive, it is likely that PCR will be positive.
Also you have impaired glucose tolerance and fatty liver on USG which could be either Non alcoholic fatty liver or HCV related. It is worthwhile to get a lipid profile also done.
You need to reduce weight if you are over weight and be on a low carbohydrate diet to normalize sugars.
If your HCV PCR is positive then you will need a genotype and the treatment for the same with interferon.
This will help to normalize ALT levels.
Hope this answers your query.
Please let me know if there are any further queries.
Wish you a speedy recovery.