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Fatty liver and HCV
Dec 1, 2007

Hi Dr McGovern,

On a random blood test my ALT was over 200 and my AST was high too. My doc did a liver biopsy which found moderate steatosis with mild iron elevation. I was was immunized for HBV in college a while back and tested negative for HCV w/ 2 PCRs and have had 2 negative antibody tests 15 months after last possible exposure. I've also had a negative HCV In-Suto Hybridization of my biopsy samples. Do you think we can rule out conclusively hepatitis viruses? My doctor says its "simple fatty liver". Sincerely appreciate any help you can offer.

Response from Dr. McGovern

Yes I think you can be assured on that point. You do not appear to have viral hepatitis.

If you are overweight, I would recommend starting to work on weight reduction with diet and exercise. If you drink daily (including beer) I would cut that out.

You should also be checked for triglycerides and cholesterol and insulin resistance to see if these are contributing to your fatty liver.

Fatty liver can lead to scarring if there is inflammation as well so you will need follow up by a specialist in this area of liver disease called steatohepatitis or NASH - non-alcoholic steatohepatitis. With the ALT of 200, I don't think it is just fatty liver (a benign condition) but steatohepatitis (fatty liver with inflammation).

Initiation of therapy in HIV/HCV conifection.
How long without symptoms

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