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Getting Hypochondrium Pain. Hbsag, Hcv Ag, Hiv, Vdrl Showed Slightly Elevated And Hepatitis Negative. What's Wrong?

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Posted on Fri, 16 Nov 2012
Question: hi sir....i hav deranged liver profile and i am hbsag,hcv ag, hiv, vdrl negative.....6mnth back got needle prick took art for that....1mnth duration.....now all values of lft slightly elevated and ast and alt are twice of normal value and alp iz 250....mild dul aching pain in right hypochondrium.....yellow urine,malaise.....what it can be?
my hiv,hepatitis b and c, vdrl , malaria antigen all are negative
doctor
Answered by Dr. Charles S Narasi (2 hours later)
Hello, XXXXXXX,
I am glad to hear that your Hepatitis profile is
negative. I am assuming that you were tested at
least twice for Hepatitis-C after the needle prick.
Since there is an incubation period, the initial
tests could come back negative. That needs to be
re-tested and ruled out.
What other conditions can cause abnormal liver
tests ?
Well, you have to always think about alcohol,
drugs, including over the counter medications
such as Ibuprofen, excessive acetaminophen etc.
Certain prescription antibiotics like tetracycline,
sulfa drugs can affect the liver.
You mention pain in the right hypochondrium.
Your gallbladder is underneath the liver on the
right side. If you have had dark urine, fever, chills,
nausea, vomiting, pain starting in the upper right side
of the abdomen and radiating to the back, then we
have to rule out gallbladder disease, like gallstones.
If you have not had a sonogram of the gallbladder,
I suggest that you get this as soon as possible.
If you are overweight, there is a possibility of
"Fatty Liver". This may be associated with elevated
lipids, type-2 diabetes.
There are certain rare conditions called
Alpha-1-Antitrypsin deficiency (Genetic) which could
cause liver test abnormalities.
Rare metabolic disorder, Amyloidosis can do this also.
If the liver tests remain abnormal, after you have ruled
out gallbladder problems, you may need to have a biopsy
of the liver to determine the cause. This is done under
local anesthesia with x-ray guidance to take a tiny piece
of the liver without open surgery.
Make sure that you have a complete blood count,bleeding
and clotting tests.
Hope you can discuss these with your own doctor.
Wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (14 minutes later)
sir thank you for the reply......i have tested for hep c just once but that too after 6months of needle prick....that much duration isnt long enough to overcome incubation period?.....i checked my temp....it is 99f and that dull aching pain is not now....urine is dark yellow...febrile....i took a course of azithromycin last week for acne....fasted for 7days....only took fruits and potato in diet....i didnt have ultrasonogram....but i ll get it done asap....i am occational drinker....didnt consumed in past 3months....i am obese...taking thyroxine 25mg daily for hypothyroidsm too...kindly suggest me how to proceed
one thing more i remember....i had an history of sexual contact 5months back....but these infections too ruled out by these tests....can some other STI can cause deranged liver profile?
thats the XXXXXXX i know about 5-6months
help me out sir
doctor
Answered by Dr. Charles S Narasi (3 hours later)
Hello, XXXXXXX,
If the Hep-C was negative after six months of exposure, you
don't have Hep-C.
STDs can affect the liver but has to be very advanced.
The chances of that is unlikely.
That leaves possibility of gallbladder problem very likely.
Underactive thyroid is associated with higher incidence
of cholesterol gallstones.
Please get a complete blood count and the sonogram.
Wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (20 minutes later)
thankyou so much sir....i ll contact you after getting sonogram....as my blood counts are normal....so only usg is left....thank you so much sir.....
doctor
Answered by Dr. Charles S Narasi (1 hour later)
Hello, XXXXXXX,
You are very welcome.
Look forward to hearing from you again.
Good luck.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (9 hours later)
sir recently i got my usg done....and report says mild enlarged liver and echogenic in echopattern and fatty liver grade1.....rest all usg abdo is normal....
what can be the cause sir?obesity?hypothyrodism?occational alcohol intake?post exposure prophylaxis 6months back?fasting for 7days?azithromycin course for acne?
waiting for hepA viral marker report to come....
rest all viral makers are negative....
i am doing my temp charting too.....and it is coming out to be normal now....
should i get worried about something?
doctor
Answered by Dr. Charles S Narasi (5 hours later)
Hello, XXXXXXX,
I am glad they did not see gallstones. So, Fatty liver
is the cause of your abnormal liver tests. The main
treatment for this is losing excess weight. Even brisk
walking 2-3 miles a day three times a week will be
very helpful. Cut back on fatty or greasy or fried foods.
Start eating fresh fruits and vegetables. You can also
take Super B-Complex vitamin pill once a day along
with 800 i.u. of Vit-E. Fish oil capsule (Omega-three)
1000mg. once a day also helps. Your fatty liver is
mild and can be completely reversed with these
measures. Don't worry.
Best of luck.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

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Getting Hypochondrium Pain. Hbsag, Hcv Ag, Hiv, Vdrl Showed Slightly Elevated And Hepatitis Negative. What's Wrong?

Hello, XXXXXXX,
I am glad to hear that your Hepatitis profile is
negative. I am assuming that you were tested at
least twice for Hepatitis-C after the needle prick.
Since there is an incubation period, the initial
tests could come back negative. That needs to be
re-tested and ruled out.
What other conditions can cause abnormal liver
tests ?
Well, you have to always think about alcohol,
drugs, including over the counter medications
such as Ibuprofen, excessive acetaminophen etc.
Certain prescription antibiotics like tetracycline,
sulfa drugs can affect the liver.
You mention pain in the right hypochondrium.
Your gallbladder is underneath the liver on the
right side. If you have had dark urine, fever, chills,
nausea, vomiting, pain starting in the upper right side
of the abdomen and radiating to the back, then we
have to rule out gallbladder disease, like gallstones.
If you have not had a sonogram of the gallbladder,
I suggest that you get this as soon as possible.
If you are overweight, there is a possibility of
"Fatty Liver". This may be associated with elevated
lipids, type-2 diabetes.
There are certain rare conditions called
Alpha-1-Antitrypsin deficiency (Genetic) which could
cause liver test abnormalities.
Rare metabolic disorder, Amyloidosis can do this also.
If the liver tests remain abnormal, after you have ruled
out gallbladder problems, you may need to have a biopsy
of the liver to determine the cause. This is done under
local anesthesia with x-ray guidance to take a tiny piece
of the liver without open surgery.
Make sure that you have a complete blood count,bleeding
and clotting tests.
Hope you can discuss these with your own doctor.
Wish you the very best.