First of all, thank you for such a wonderful community. I would like to get a second opinion on my current treatment. This is my first post here, so if anything is incorrect, I apologize in advance.
I have hepatitis B and took tenofovir for eight years. In 2023, I was unable to get my medication on time and missed it for about one and a half months. After that, I started experiencing pain, and my urine color changed. I went to the hospital and was diagnosed with very high ALT (around 800) and AST levels.
Following this, my doctor recommended a one-year treatment of weekly Interferon injections. This treatment ended in July 2024, and my test results were only slightly above normal (e.g., AST: 14 and ALT: 15). Since then, I have been getting blood tests every two months, and my results have been gradually increasing.
Last week, I started experiencing whole-body itching, and my urine turned brown. I immediately went to the doctor for a blood test, and the results showed AST: 400 and ALT: 1200. I was shocked. My doctor immediately prescribed Vemlidy, and I have been taking it for two days now.
What are the risks in my case? How can I recover? What might have caused such a sharp increase? I am extremely worried, and Google searches are making me fear the worst.
Welcome to the forum and thank you for sharing your story. Sorry to hear about your issues.
It is unclear in your case why you were not restarted on antiviral treatment when you had high ALTs. That said, it is common to have post-treatment ALT flares, which indicate your immune response is trying to clear the HBV-infected cells. Given the long-term elevation/inflammation and presumably non-clearance of HBV, you have been restarted on antivirals to lower the virus replication and prevent any more inflammation from happening. This should lower your ALT levels and reduce your symptoms fairly quickly.
Liver damage in these instances are seen when patients go of antiviral therapy, but can generally be reversible with appropriate management over time.
Dear @ThomasTu , Thank you so much for the response. Next week I have to go and do the blood test again. Hopefully, it come out with reduced levels. I am eating a healthy diet now. I don’t drink alcohol.
@ThomasTu , Let me update you on the results.
After taking Velmidy for a week, I went back to the hospital, and my results were significantly high—AST: 800, ALT: 1600. I expected the numbers to be on a downtrend since I was taking the medicine, but they weren’t. So, the doctor advised me to be hospitalized for daily monitoring.
After five days in the hospital, my enzyme levels seemed to be trending downward. Today my current levels are AST: 478 and ALT: 1100. Although they are still very high, I believe I can recover in a few weeks—I hope so.
Hi @Lwin,
Thanks for the update. It does take some time for patients to see the normalization of their numbers. Be patient and give it a couple of months to get there. You will get there and even be surprised by how well these antivirals work. Remain hopeful. Best, Bansah1
Thanks for keeping us up to date with how you’re going. I agree with @Bansah1 that it may take time to completely normalise your ALT results, but it looks like that it’s going the right way! Good luck and hope all keeps going well. Please keep us updated!