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Obstetric cholestasis or hcv? Please help
Feb 20, 2012

Good morning. I am currently 36 weeks pregnant and I have been having abnormal LFT's. The only one that is abnormal is ALT which is only modestly abnormal at 1.5 - 2 times the upper limit. Dr thinks it is cholestasis of pregnabcy however after reason online I have found that rise I'n ALT alone is usually not infighting of cholestasis and that cholestasis usually causes a rise In bile acids. From what I've read a raise I'n ALT alone is usually hepatitis related. I work I'n healthcare and have had occasional exposure to blood. Vaccinated againsed hep a and b and am currently awaiting results of hcv serology. I'd also like to mention I have been diagnosed with thrombocytopenia. Do you think these changes are pregnancy related or could be hcv related. I have also been suffering lack of appetite and nausea as well as fatigue. I hope you consider my question as I am I'n great distress worrying about my baby. I have not found a question similar to mine I'n the archives so I'm hoping you can provide me with some insight In this difficult time. Thankyou

Response from Dr. McGovern

If you are involved in healthcare and have had an exposure of concern in the past, it is certainly reasonable to check for HCV infection. You can do this by getting a HCV antibody and an HCV RNA test for virus. The latter test would be important if you think you had a recent exposure.

However, ALT can be modestly elevated if you are overweight, have a high cholesterol, or have high triglycerides...so there are many reasons for a mild elevation in ALT and most likely you will NOT have HCV.



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