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Ask the Experts about Hepatitis and HIV Coinfection
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Why is my ALT elevated now after conclusion of PegInf Therapy?
May 4, 2009

Finished w/ 48 wk HCV therapy Pegasys & Copegus. HCV cleared (undetect. at wk 6) (geno 2a)(9million vl baseline)baseline ALT was 55, dipped to 39 at wk 4, and steadily increased to mid-60s......until final lab and it jumped to 87. I don't drink at all and did nothing different than prior 48 wks. AST baseline was 43 and dipped to mid/high 30s until last lab and jumped to 52. These final readings are the highest I've ever been. What do you make of it Dr.? Thank you so much for giving us HOPE. You and your work ... and all Hepc sufferers are always in my prayers.

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   Response from Dr. McGovern

It is unclear to me when you say "final lab" - was this on treatment at week 48? If so, this is actually common to have elevations of ALT on therapy.

As for your response to treatment - it sounds like you have done exceedingly well and will hopefully have sustained clearance of virus at 72 weeks (six months after therapy has stopped) - this would be consistent with cure.

If you still have abnormal ALTs after therapy is over, I would wonder about an element of fatty liver. Ask your doctor if you are at your ideal body weight, if you have insulin resistance, or high triglycerides.



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