Hepatitis c?
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please answer.
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I agree with Snout that your brother may be in an acute infection stage of HCV. Fortunately for your brother, HCV is usually a slowly progressing disease. That does not mean it should be ignored. It does mean that he will have time to deal with his addiction first, and then he can be treated. I would highly suggest that he looks into treatment because the younger you are, and the lower your viral load is, the better chance you have of clearing the virus. If left untreated, HCV will cause fibrosis, which is scarring of the liver. When the liver becomes very damaged, blood cannot flow through it and the liver won't be able to do an effective job of filtering the blood and performing metabolic functions. It also dramatically increases the risk of liver cancer. I have seen people who have waited too long to seek treatment, and then the only option is a liver transplant. However, 12,000 people die each year waiting for a liver. Dying from end stage liver disease is a terrible way to go. He is young and hopefully will seek treatment, first for his addiction, then for hep c. Best wishes.
I am going to work my way backwards. The normal levels for the ALT and AST liver enzymes are: ALT 7-56. AST 5-40. However, of course, that is based upon the entire clinical picture. A value in the 2000 range is obviously very, very high and very, very concerning.
It actually is very uncommon for patients with hepatitis C to have values this high, and much more common for patients with a viral type of hepatitis, either A or B, to have much higher levels.
This is a very complex disease and warrants investigation. It would be a disservice really to say whether or not he can survive, whether or not antivirals will help him, or whether he will need a liver transplant. In all actuality, all of these things are possible. Of course, first and foremost, he is going to have to deal with the heroin addiction as well.
I will list some good websites below for you to do further research. Best of luck to you and your family!
I don't know how they could possibly know he's had it for at least a year, unless he had a test a year ago which showed it then.
An ALT in the 2000s suggests an acute (very recent) infection, and repeat tests over the following weeks will normally show a fall back towards normal. As dede_mcm says, this is high even for acute (early) hepatitis C, but it is not unheard of.
Generally speaking, the earlier hepatitis C is treated, the more likely treatment is successful. However, if he is actively still using heroin this may not be the best time.
It is also possible he might clear the virus by himself without treatment - about one in five people infected with hep C do.
It is way premature to be thinking about liver transplants. He needs to follow up with blood tests over the next few months to see if and how much the liver inflammation gets better.
Hepatitis is a very serious disease. There is no cure.
There are several treatment options.
But it is not likely your brother will be a good candidate for treatment unless he also enters a drug program.
If he stops shooting up, and stops drinking, the medication can help stabilize his liver.
Without treatment, and with continued substance abuse, he will die.
Transplants are an option. But transplant programs do not admit people who are still using drugs or drinking. The length of time the patient has to be clean and sober varies, but is generally around 6 months.
Your brothers LFTs are very high. But I've seen go higher, and come down.
The liver is a remarkable organ.
first of all your brother will not be a canadite for treatment until he is 6 months clean of all drugs (including alcohol).
viral load has nothing to to with the extent of liver damage-
the same for alt and ast levels.
what matters is your brother needs to focus on being clean and drug free-then he can begin treatment.
people can live a normal life span with hcv providing they do not eat, drink or do things to their bodies that are highly contradictive to their disease. the downside to life span is quality of life is lowered with the progression of the damage by the disease.
if he continues to use drugs and abuse his body, there is no telling how long he has left.
i do not know how a doctor can tell a patient has had hcv since many have hcv before depression and depression before they are an addict. many self medicate without knowing that their depression stems from a virus such as hcv.
a good example is me. my symptoms started at age 8. a rash appeared on my upper chest/neck area, but since it didn't itch, the doctor at that time just shrugged his shoulders. by 12 my bones and joints were sore and stiff and achey. at 13 i began to show symptoms of mental illness-depression that was blamed on childhood problems. by 16 i slept twice during school hours, i would go to bed around 10 pm and didnt wake until about 5 minutes before the bus came to my corner. at age 24 i stayed in a mental hosptial twice. i tried many antidepressants-nothing helped long term. i had failed relationships, found pleasure in the wrong type of men.
finally at age 34 i fired the doctor whom i complained to for over 10 years that "something wasn't right". i then found a doctor that agree'd that depression just doesn't happen on it's own and from there i was lead to my liver doctor.
now, i had never had an issue with drug use-infact, as a teen pot made me more tired than i already was, so it was something i didn't care doing all that much of.
your brother has been seeking help in the wrong way by choosing to do heroin (and whatever else or whatever came before that). he believes that drugs make him feel better-just as i believed that over the counter antidepressants would make me feel better. the down side to drugs such as heroin is that they are illegal and highly addicting because whatever is in heroin is helping him feel better short term only to find once he doesn't have it, he feels just as bad as before.
chances are your brother may have had hcv infection long before he began heroin. drug use is always attention getting, however, usually it ends up being on the negative side.
now, you say his enzymes are in the 2000's (if they are he could have acute hepatitis brought on by the drug abuse and because of his hcv infection and damages from both), i think that you misunderstood-it is probably his viral load. enzymes are alt and ast levels which are markers that show the doctor the liver is inflammed. the extent of liver damage is only known well by a liver biopsy, although there are now pretty good tests they can do via blood lab to indicate the shape of the liver. i believe in liver biopsies prior to treatment because that is the best window into looking at the extent of liver damage.
get your brother help now. tell him what he feels the first week or so, is the heroin detox..but after that he may feel actual side effects of hcv.
again, the only way to treatment is becoming drug free. at this point, there are only self injected shots (interferon) and ribavirin-or infergon with ribavirin or the newest oral med along with that. (sorry can't remember the name-it is XR- and some numbers).
anyway. if your brother is serious and wants to live and wants to realise that it is the hcv that has caused the depression and the depression is what's caused his addiction, he will beat his addiction and get on treatment, otherwise, he can die if he continues to choose to live in a world of insanity.
trust me, hcv is insanity enough! treat the hcv and all his issues will lesson dramatically! heroin or any other drug use is an issue, but if you treat the hcv, a persons chances of becoming non-depressed increases dramatically, which will lower the tendency to self medicate with addicting and damaging drugs.
good luck and hugs to you and your brother!
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