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Liver question. Friend of mine, age 27, pregnant 26 weeks.

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Liver question.

Friend of mine, age 27, pregnant 26 weeks. Recent prenatal checkup doctors indicates ALT index and AST index is around 1300, and calls her stay in hospital, for a week.

She is on GILEAD for 4 days. Before taking this medicine, index has fallen to 700. After taking this medicine, index rises to 1600.

Blood test have been taken twice, results still say her ALT AST is high. Seems nothing is helping.

What can possibly be happening? And will this affect her baby?

She has Hep B originally.

Thank you so much.

Mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Mysticdoc :

Hi there,


I am Mysticdoc, experienced Internal Medicine Specialist.


I am here to help you with your concerns.

Mysticdoc :

Pregnancy is known to cause flare up of hepatitis B.

Mysticdoc :

That is wat is likely happening.

Mysticdoc :

However, this does not usually affect the baby.

Mysticdoc :

Gilead will help to reduce the risk of perinatal transmission.

Mysticdoc :

The gilead is continued till 4 to 8 weeks after delivery.

Customer:

Is the ALT AST index very high now? Is it indicating anything serious?

Customer:

Cos the hospital is not letting her discharge out

Mysticdoc :

That is the usual elevation with hepatitis flare up.

Mysticdoc :

Close monitoring is all that is required.

Customer:

Does pregnancy causes the index so high?

Mysticdoc :

Hospital admission is recommended till the AST and ALT level start trending down.

Mysticdoc :

yes it does.

Mysticdoc :

the hepatitis gets activated

Mysticdoc :

Also pregnancy itself can stress out the liver.

Customer:

Oh I see.

Mysticdoc :

does she have any symptoms?

Customer:

no other symptoms really

Customer:

She is on GILEAD for 4 days, usually how many days is expected to make the index drop?

Mysticdoc :

at least 2 weeks of treatment.

Customer:

as blood test are still saying it is even a bit higher

Mysticdoc :

but gilead still should be continued.

Mysticdoc :

And the hepatitis virus level should be checked as well.

Customer:

Will any symptoms develop?

Customer:

And does GILEAD affect the baby?

Mysticdoc :

sometimes yes --mausea, vomiting, stomach pain.

Mysticdoc :

gilead does not affect the baby

Customer:

I see. Thank you so much.

Mysticdoc :

very welcome

Customer:

One final question

Mysticdoc :

ok

Customer:

If she is discharged out, will the index suddenly rise up again?

Mysticdoc :

That should not happen while on gilead.

Customer:

Thank you so much really, your replies are very helpful!

Customer:

Have a good day!

Mysticdoc :

very welcome

Mysticdoc :

Best wishes,


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Customer:

Sure.Thank u!

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Customer: replied 3 years ago.

Dear MysticDoc,

Here are the recent results of the patient:


 


July 01 : AST 676, ALT 1315
July 05 : AST 827, ALT 1687
July 06 : AST 745, ALT 1631
July 08 : AST 579, ALT 1390, ALP 69


 


 


Q1: Is there any improvements shown, or is it still too early to tell?


Q2: How low should the values drop for the patient to be able to be discharged out of hospital?
Q3: Are there any food intake that can benefit liver function?


Thank you so much!

It looks like the levels are improving gradually.
The levels should drop below 200 to consider hospital discharge.
High fiber low fat diet will be helpful.
Avoid alcohol, tylenol.

Thanks for the update.
Best wishes
Dr Basu and other Medical Specialists are ready to help you
Customer: replied 3 years ago.

sorry i missed out the GGT values are 28, 34, 38, 44 on the rise. what does that indicate?

GGT is also specific for liver injury.
But the values are rising very slowly.
Does not suggest anything else.
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