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[QUOTE=Avalon]NY Mom, I am curious as to what you decided about treatment. I also have genotype 2b and have never had an abnormal liver enzyme result....until now. I had routine bloodwork just prior to back surgery in Nov.; AST was 160 and ALT 325. Unfortunately, I just found out about these results a few weeks ago; a subsequent blood test showed levels dropping but still high -- 118 and 246. I was thinking the reason might be the Percocet I was taking for the back pain (has Tylenol in it, which is toxic to the liver)...combined with the occasional martini (yes, I was still drinking)...I have read that alcohol enhances the toxicity of the Tylenol in the Percocet.

I realize I was playing with fire, continuing to drink. However, since I had never had elevated enzymes, and my liver biopsy in 2002 revealed minimal damage (1), and I figure I've had this since 1969 so there have been many years of social and sometimes heavy drinking without apparent damage, I rationalized that I could continue to drink. I was supposed to have another biopsy in 3 years (which would be this year), and I figured if it showed the damage had progressed, I'd stop drinking then. The gastro had recommended treatment back then, by the way, but it was not a good time at work (as you said, never a good time) and I was afraid of side-effects during and/or after treatment.

So now I suddenly have high enzymes. The gastro doesn't think it was the Percocet (wasn't taking much of it) and he of course said I shouldn't have been drinking at all. He is strongly recommending treatment now. He said the conservative approach was OK when all my tests were normal, but now something is clearly happening and I should go forward with it, especially given the success rate with my genotype.

Again, it's a bad time at work....having just been off for 8 weeks with back surgery. Additionally, I have an opportunity for a new job that would mean significantly more money....well, now I'm afraid to start a new job and then be unable to function due to fatigue or other side-effects. I'm also afraid of health complications after the treatment.

The gastro has indicated the treatment could clear me completely of the virus. (Other posts here have disputed that.) I have an appointment with him in a few weeks and will have another blood test beforehand to see where the enzymes are at that point. Even if they're back to normal, I'm sure he will still recommend treatment. I told him about the problem with work, but he says this is the rest of my life at risk.

I'm sorry for the long post, but I just wanted to see if anyone had any words of wisdom. I guess I'm backed into a corner now....I feel I'll have to go ahead with the treatment. What else can I do? I'm afraid there's more damage going on in there.

I am so darn angry that my drug use 30+ years ago has come back to haunt me, after having turned my life around and living as a solid, upstanding citizen for 27 years. No one ever told us that the hepatitis we all got back then, which we thought was funny since we were all in the hospital together, would cause such serious problems later. Well, enough feeling sorry for myself. Just wanted to see what NY Mom decided to do....and to share my dilemma. Thanks for listening![/QUOTE]

A lot of assumptions are being made here and they need to be tested out to see whether or not they are accurate.

First, since the enzymes are going down, it is possible they would normalize if you decided to take control of what you can and see what that nets you in terms of the enzyme levels. If you are female, there are hormonal implications that you might explore here to determine whether it is the hepC that is causing the rise. Doctors, even female ones, often overlook significant issues that are particular to women's health. Consult your OB/GYN for an assessment of your hormones, thyroid, and general condition and take this into account.

I don't want to beat you up about your drinking, but it definitely could be that. I trust you know now that that is now a huge risk to you and will leave it at that. It is too early to tell if this is the actual cause. I would want to know what else might be at play before jumping to this conclusion. Hepatitis C is not the cause of everything all the time, even liver enzyme fluctuations.

You need another biopsy. You need another biopsy in which the pathologist compares the slides from both biopsies to determine whether there has been changes. Two pathologists can look at the same slide and come to a different conclusion, so have the same person look at both slides and make a comparison report.

Once you have all that information, then you are in a position to decide what course of action you will take and what you might do across a spectrum of choices. Every one of the choices will have some risk. The trick is to choose the one that is the best for you based on all the pertinent information about you. Results of studies are about other people.

Smoking (second hand smoke, too, by the way) is another wild card here that causes damage to the liver. Exposure to it can raise your liver enzymes.

Just a note about the statement of "clearing the virus." Absolutely it is possible to completely clear the virus, but we have no 100% way of measuring that result at this time. For one thing, we only test serum and whole blood studies have shown that sometimes a "negative" result isn't. Additionally, newer tests are detecting virus where the older ones did not. So, while the virus very well could be eradicated, we have no way to measure that at this time. The safest thing to do is to take charge of your lifestyle because it is wise to eliminate toxins and add healthy choices before and even after a course of successful treatment. Alcohol and smoking should NEVER be added back into your life. Your liver is never going to be a young liver again. There will always be a vulnerability there, healthwise.

My advice? Get into a healthy place. It's work, but worth it. Nothing you can do about past behavior now except vow not to repeat it. Get the biopsy, the other consultations you need, and then make the decision from as informed a place as you possibly can.

I hope this helps,


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