Enlarged liver, right abdominal pain

What do my lab results mean?
1

26m, 180 cm, 82 kg, no family history of liver diseases

Since January this year, I started to have mushy stools and pain on the right side of my abdomen. I also noticed that I’m more tired. This pain feels like either burning or stabbing and it was worse after consuming alcohol. I did some blood tests and got an elevated ALT result of 150. I decided to stop drinking alcohol completely, and now I don’t drink for 3–4 months. But my ALT stays around 66. My recent results:

HbsAg 0.2 ratio (ref <1.0)
! Anti Hep B surface antibody >1000 IU/l (ref <10)
! Hep B virus core antibody 6.0 ratio (ref <1.0)
! Cytomegalovirus IgG antibody 50.4 AU/ml (ref <6.0)
Cytomegalovirus IgM antibody 0.1 ratio (ref <0.8)
! EBNA antibody 67 U/ml (ref <5)
HIV neg
Hepatitis C virus antibody neg

! ALT 66 U/l (ref 0-45)
AST 31 U/l (ref 0-35)
ALP 115 U/l (ref 0-120)
Bilirubin total 10 umol/l (ref <21)
GGT 22 U/l (ref 0-55)
LDH 173 U/l (ref <248)
Cholesterol total 4.34 (ref 2.50-6.50)

ESR 2 mm/hr (ref <15)
CRP <1 mg/l (ref 0-10)

HbA1c 33 mmol/mol (ref 20-42)

The PCP suggested that my liver might be enlarged under the right ribs, and I had an ultrasound. Ultrasound seems normal, no gallstones.

I also had a FibroScan 5.1 kPa, 160 CAP.

As I understand, I have cured Hepatitis B infection. But why my HbsAg ratio is 0.2 instead of 0? Can I have an occult HBV infection and do I need to test for HBV DNA? Could this increase in ALT be unrelated to hepatitis B?

2

Welcome @user3914

I’m not a doctor, lived experience 40+ years.

I really recommend that you see your doctor to get a full picture

of what is happening with your body.

Others might be able to tell you more about your results.

@Bansah1 @ThomasTu @john.tavis

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3

Hi @user3914,
There is evidence of liver inflammation, as suggested by the elevation in your ALT. Based on your results, it does not seem this is due to hepatitis B. The results indicate this (HBsAg ratio of 0.2; anything less than 1.0 is considered negative), and an HBsAb level of 1000 IU provides higher antibodies to protect you. The core antibody results confirm your past exposure. Hepatitis B does not appear to be the issue here. There is no issue with HIV or hepatitis C.

This could be related to drinking, especially if it’s been a long-standing habit. Alcohol can cause liver inflammation and damage. Please try to discuss this further with your provider to find ways of helping you remain sober. It is important to give your liver the chance to heal and repair any damage.
Best, and keep us posted. Bansah1

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4

Hi all,

My interpretation is the same as @Bansah1 . This is highly unlikely to be HBV, but there are lots of liver diseases, and you clearly are having liver problems. I strongly urge seeing a reputable hepatologist.

I wish you the very best.

John.

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