Dr., I just received the news I am HCV-positive (HIV Negative). I am a 42-year-old female. I used IV drugs foe several months 13 years ago. I have a history of alcohol abuse, but have only used alcohol here and there the past 5 years. While I do not yet know my viral load, as the PCR test was qualitative, my metabolic profile had the following results: ALT: 111 (Normal for the testing lab is 24-59) AST: 41 (Normal = 9-33)

All others in normal range. My questions are: How "bad" are my ALT & AST levels, and what can I expect when I see the GI? Thanks for your help.

I would recommend a few things which I am sure your physicians have already performed:

1. A HCV viral load to see how high the virus level is. This is helpful to know when and if you are starting treatment to assess your response. 2. A HCV genotype. If you have genotype 2 or 3 I would proceed with treatment since the results are so good and you only need 6 months of therapy. 3. If you have genotype 1 or 4, then I would proceed with a biopsy to see how much liver damage you have. I recommend a liver biopsy in this situation since the results are less good (but still certainly worth treating since you have a better than 50 percent chance of responding) and you will need 48 weeks of treatment.

4. No alcohol until you figure out the rest since alcohol contributes to scarring. 5. If you undergo treatment, take ALL doses - adherence counts!

Dr. McGovern