ALT level after 10 weeks of tenofovir therapy

Visited my doc today. I have been diagnosed with chronic HBV. After 10 weeks of tenofovir therapy my ALT level has decreased from 178 to 152. Is this normal? Should I be concerned? My doc took a “ wait and see “ and test again in 3 months? Just wondering if I am in the right course of action. Regards. Mike

Hi Jmm,

in my case it took approx. 10 months for the ALT and AST to normalise.
They have been within range since. I keep my fingers crossed that it is sooner in your case.

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Thanks for the reply.we will see!

Hi @Jmm,
Welcome to the community. Yes, I agree with @Natti, it takes a couple of months to get it back to normal range. Keep taking your medicine and give it time. Some patience will be needed here. Don’t worry too much about it, because it will happen at some point. 2 and half months in, give it some more months. Best, Bansah1.

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Thanks. I will wait and hope. Mike

Did the viral load lower?

That is scheduled with next blood work in mid August. Doc said we will begin to measure viral load quarterly beginning in August. Thanks.

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Please let me know. I’m curious as to how fast the number of viruses decreases. I’m also on meds. Take care!

I found this test result that was taken 2 weeks before I started on Tenofovir everyday.

HBV DNA qnt-mayo


Out of Range


Normal reference: undetected

Non-Fasting Specimen. Result in log IU/mL is 8.34. -------------------ADDITIONAL INFORMATION------------------- The quantification range of this assay is 10 to 1,000,000,000 IU/mL (1.00 log to 9.00 log IU/mL). Testing was performed using the cobas HBV test (Roche Molecular Systems, Inc.). Test Performed by: Mayo Clinic Laboratories - Rochester Superior Drive 3050 Superior Drive NW, Rochester, MN 55905 Lab Director: William G. Morice M.D. Ph.D.; CLIA# 24D104059

How do you interpret this result ? Can anyone share ?


My viral load was tested three months after starting medication and it was already undetectable. However, ALT and AST did not budge for approx. 8 months, then they spiked by 1/3 and then after 10 months on medication dropped to the levels within mid-range for the healthy individuals.
We looked for other possible causes but we could rule out other Hepatitis types (D, C, E, A) and God knows what else.

Hi @Jmm,

The only thing that can be said about your results is that you have a high viral titre, but this result alone cannot say anything about your liver health or prognosis. We know that this is expected to dramatically reduce in the upcoming months due to your starting of antiviral therapy.

Hope this helps,