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Negative HCV test, but doubling ALT level?
Feb 13, 2012

Hi there, I had a possible HCV exposure about 5.5 monthes ago. For the past 3 months I have been suffering from chronic fatigue, diarrhea, and nausea, as well as skin itching. I had some LFT's dont at 4 months past exposure and the level was 40. then I had them drawn again and the level is now up to 86. My Dr ordered an HCV antibody and I went for the test at 5.5 months after exposure (23 weeks) it was negative. Do you think that it is still possible I could have HCV infection. Or is that now ruled out due to the neg test at 5 months. My Dr doesnt know what to think and Is going to converse with some collegues before my next appointment on what to do next. I'd really appreciate your opinion while I wait. Thanks

Response from Dr. McGovern

LFTS can go up from a variety of things. Yours are only mildly abnormal. I doubt you have acute HCV infection, because I would have expected your antibody to turn positive by 5 months. However, if there is some other possible more recent exposure, you can consider a HCV RNA test. I assume that you have already had testing for other hepatitis viruses.

Mild LFT elevations can be due to medications or fatty liver - the risk factor for this is high cholesterol, high triglycerides, diabetes, or being overweight.

Definition of an HCV non-responder
Liver Biopsy results.

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