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relatioship bet VL and Enzymes
Aug 19, 2002

Dear Dr. Could you kindly ellaborate on the relationship of the enzymes and the VL. In a situation where the patient is diagnozed with HEP C. When the liver enzymes goes down to normal level , does that mean the VL should be dropping as well? Any further explanation is highly appreciated.

Response from Dr. Rodriguez-Torres

Ther is no relationship between the viral load and whatever is happening in the liver.You may have severe liver necrosis and cirrhosis with low viral levels and very little disease with high viral levels.Hepatic tests are normal in up to 25% of all HCV patients,and we may have from mild to severe disease in this population.Patients with HCV ,usually have fluctuating levels of ALT,and this do not mean the disease is worsening or improving.During therapy with IFN,a decrease usually is seen when patients are responding but not always.Even when using Pegasys ,patients that are responders,and go on to be sustained responders,sometimes never normalize ALT,till the drug is stopped.The only way to assess the response to therapy is to check for HCV in the blood.

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