Slightly raised ALT and AST

dear experts,
My other LFTs like GGT, Biliburin, etc. are normal
I am on TAF and my viral load is undetected.
My ALT is 51 and AST is 45.
My doctor is guessing that it might be due to Fatty liver.
@availlant can I have your views please

Take 2-3cups of coffee daily take one cup of green daily,eat more of fruits and vegetables.
Then after 4 months check Ur lft test again

What is the level of your Hbsag quantitative and liver stiffness in Kpa

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Dear @Suresh786 ,

These liver enzyme levels are only very mildly elevated and you should not be too concerned. Normal levels vary in different parts of the world. For instance in central Europe ALT is considered normal upto 50 IU/mL.

Mildly fatty liver is a definite possibility or alternatively alcohol consumption. These can be managed by lifestyle changes.



Hi @Suresh786,
I agree with @availlant. Your numbers are mildly elevated. If this is the first time you are seeing such increase in your result, don’t worry but keep an eye on. If it stays elevated through multiple test, then that can be concerning. Some HBV patients develop fatty liver in the process, so don’t feel overwhelmed because you are not alone. Keep up with your appointments and monitoring with your provider. Best, Bansah1


9.4 is my latest kpa

I had HDV but its cleared by taking Interferon Injections for 50 weeks

I am currently taking TAF for HBV


9.4 kpa is quite high. Hopefully you will lower it in the future.

You didn’t mentioned your Hbsag quantitative.

My Kpa is 4.95 and Hbsag quantitative 790

Hey man, congratulation on clearing HDV and 50 weeks on interferon its definitely tough. NUC therapy is shown to lower the fibrosis score in the long term. This effect does not show immediately unfortunately. Given that you had HDV and while on Interferon one is probably not so much active, one could also develop fatty liver in the process and this is reflected on your fibrosis score. As other mentioned this could be managed with lifestyle changes and monitoring. Take care

I noted that you mentioned that you have viral load undetected and I am assuming you are still hbsag positive.
More experts will chime in on this but if this is not cleared there is still a possibility that hdv could reactivate.
Are u monitoring the hdv after the ending of therapy to see if its still supressed?
In this case you would need te discuss it with your doctor

Dear @Suresh786 ,

When did you stop taking your pegIFN?


dear @availlant @anonml

I started pegIFN in March 2022 and completed Feb 2023.

I did HDV test after six months of pegIFN and it was zero then again I did test in April 2023 it was zero. Then I did test in Dec 2023 it was zero.

Yes my HBsAg is still positive. I am taking TAF.

my ALT and AST vary from 30 to 51 over the last year as i have done test few times. Other LFTs are normal.

My fibrosis was 12.9 then 11 and now 9.4

Hey @Suresh786
Do you workout or exercise?
Keep in mind that strenuous exercise can lower your liver enzymes for up to 7 days.
It happens to me all the time and I often take a rest week before testing.

Dear @Suresh786,

Elevation of liver stiffness during pegIFN therapy can occur. This does not necessarily mean that fibrosis is increased but instead can be derived liver inflammation due to immunostimulation in your liver. Your slow decline since then is also normal and likely reflects removal of pegIFN and HDV cure as well.

Your ALT is not concerning.



thanks @availlant
how to bring my Fibrosis 9.4kpa down?