Examining hepatitis C's impact on liver functioning and liver enzyme levels
Hepatitis C is a contagious liver disease caused by the hepatitis C virus. This viral infection can lead to serious complications if left untreated, such as liver failure or death. Fortunately, doctors can successfully treat chronic and acute hepatitis C using oral therapy.
When a hepatitis C infection is present, a person may experience a significant increase in liver enzymes, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). These enzymes leak into the bloodstream when liver cells are injured by the virus, reflecting liver inflammation or damage. ALT elevation is usually one of the earliest lab abnormalities detectable after HCV infection, often appearing soon after HCV RNA becomes detectable.
Beyond ALT and AST, other liver function blood tests used to evaluate patients with potential hepatitis C infection include alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT), which can also indicate liver dysfunction though they are less specific for viral hepatitis. HCV antibody testing (serology) is used first to detect past or current exposure to the virus; however, the presence of antibody does not confirm active infection or immunity. HCV RNA testing (molecular nucleic acid test or NAT) is the gold standard to confirm current infection and detect viral replication, becoming positive 1-2 weeks after exposure.
In some cases, a liver biopsy or non-invasive fibrosis assessments may be performed to evaluate the degree of liver inflammation and scarring caused by chronic hepatitis C. Additional tests such as liver synthetic function markers — including bilirubin, albumin, and coagulation tests (e.g., INR) — may be used to assess overall liver function and severity of liver disease but are not specific for hepatitis C diagnosis.
It's important to note that changes to a person's ALT levels do not mean the liver is functioning better or worse. In most cases of chronic hepatitis C, liver function test results tend to vary. Doctors may order other blood tests to evaluate liver function if necessary.
In the acute phase of hepatitis C, a person may experience symptoms such as fever, fatigue, appetite loss, abdominal pains, nausea and vomiting, yellowing of the skin or eyes, and dark-colored urine. However, in chronic hepatitis C, there may be minimal or no symptoms. Early diagnosis of hepatitis C is essential to avoid complications.
Without treatment, hepatitis C can lead to severe complications. Fortunately, various drugs with Food and Drug Administration (FDA) approval to treat hepatitis C include elbasvir and grazoprevir (Zepatir), glecaprevir and pibrentasvir (Mavyret), ledipasvir and sofosbuvir (Harvoni), peginterferon alfa-2a (Pegasys), and sofosbuvir (Sovaldi). The treatment duration and specific medication may vary depending on the particular genotype of the virus, with Genotype 1a being the most common in American adults.
In conclusion, elevated liver enzymes—primarily ALT and AST—signal liver injury from hepatitis C, while comprehensive evaluation uses serology, viral RNA testing, and other blood tests to define infection status and liver function integrity. Early diagnosis and appropriate treatment can significantly improve the prognosis for those with hepatitis C.
- Hepatitis C treatment can involve medical-conditions such as chronic and acute hepatitis, which are often treated with therapies-and-treatments like elbasvir and grazoprevir (Zepatir), glecaprevir and pibrentasvir (Mavyret), ledipasvir and sofosbuvir (Harvoni), peginterferon alfa-2a (Pegasys), and sofosbuvir (Sovaldi).
- A liver biopsy or non-invasive fibrosis assessments may be required to evaluate the extent of liver inflammation and scarring that can occur due to chronic diseases like hepatitis C.
- Chronic hepatitis C often presents with minimal or no symptoms, but a significant increase in liver enzymes like ALT and AST can indicate that the liver is affected by the disease, even in the absence of visible symptoms.
