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Hepatitis!!

Fuzzyhead

Senior Member
Messages
372
I had my bloods done 18 months ago and my ALT was 91, i had an ultrasound of my liver and everything was ok apart from i have 1 small gallstone. I saw a gastroenterologist who did further bloods and the EBV IgG was reactive. Also autoantibody screen showed positive nuclear antibody result with homogenous HEp2 pattern. The remainder of the antibody screen was negative including sma. He wants to do a liver biopsy to test for autoimmune hepatitis. Anyone else had this?
 

Gingergrrl

Senior Member
Messages
16,171
My liver enzymes in 2012 during mono ALT & AST were off the charts in the 500's and they almost hospitalized me for liver tests. But when the mono resolved, the liver tests went back to normal although it took several months.

ETA: with my re-activation of EBV and ME/CFS my liver tests have remained normal.

2nd ETA: During mono, they tested me for all the different types of hepatitis and all were negative.
 
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Fuzzyhead

Senior Member
Messages
372
I know i had EBV when i was 18 (45 now) but it said on my results past infection more than 8 weeks ago. So does that mean it's just still in my bloods from 27 years ago or does it mean i have had it again since?
 

Gingergrrl

Senior Member
Messages
16,171
Do you know if the IgM or early antigen test was positive or only the IgG? There is lots of controversy in this area but ME/CFS specialists will say that positive IgM or EA test show clear current infection or re-activation vs IgG which shows past infection.
 

andre79

Senior Member
Messages
122
Hi, i am not expert but I think that EBV IGG positive alone is an indication of past infection. 95% of worlwide adult population has a EBV IGG positive. In your case is normal because you had mononucleosis in your teens, and the antibodies usually remain your whole life. Now, if we are talking about reactivation, you would have EBV IGM positive. There are two more antibodies E AD and EBNA that could indicate you if this a new, past infection or reactivation. But i think, that if you have IGM negative with the other three positives then is past.
 

acer2000

Senior Member
Messages
818
I'd be curious if you do get the biopsy what it shows. I have had similar elevated liver enzymes with CFS and no real explanation. Tested negative for the "typical" hepatitis viruses.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
I'd be curious if you do get the biopsy what it shows. I have had similar elevated liver enzymes with CFS and no real explanation. Tested negative for the "typical" hepatitis viruses.
We have elevated liver enzymes as a matter of course. Unless they are very high I wonder if a biopsy is necessary. The liver is stressed in ME quite apart from other issues.
 

Daffodil

Senior Member
Messages
5,875
If EBV IgG is high enough, it could mean reactivation..this was implied by some people's success on Valcyte at Stanford.
 

Gingergrrl

Senior Member
Messages
16,171
If EBV IgG is high enough, it could mean reactivation..this was implied by some people's success on Valcyte at Stanford.

@Daffodil I have heard this, too, and that some CFS doctors consider the IgG alone as a re-activation b/c our immune systems are not normal. This is where it gets confusing to me!
 

Gingergrrl

Senior Member
Messages
16,171
elevated lymphocytes especially elevated cd8 t cell lymphocytes can help back up the diagnosis of ebv reactivation?

@heapsreal Is this test part of the lymphocyte subset panel? I am looking at my test results from July and there are two tests with CD8 in them. One says "CD8 suppressor T cells" and one says "Absolute CD8+ cells." I don't know what this means but if I am reading it correctly all of my numbers are in range and are not elevated (yet I had positive EBV on all tests except PCR.) The test that was really low was my Natural Killer Cell Functioning test which was only five.
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,089
Location
australia (brisbane)
@heapsreal Is this test part of the lymphocyte subset panel? I am looking at my test results from July and there are two tests with CD8 in them. One says "CD8 suppressor T cells" and one says "Absolute CD8+ cells." I don't know what this means but if I am reading it correctly all of my numbers are in range and are not elevated (yet I had positive EBV on all tests except PCR.) The test that was really low was my Natural Killer Cell Functioning test which was only five.

Infections

In viral infection, the elevation in total lymphocyte count is caused by an increase in the absolute count of CD8 T cells. This occurs most dramatically in Epstein-Barr virus infection, but is also associated with other viruses such as acute CMV infection. The cytotoxic CD8 cells are able to kill infected cells, thereby limiting the dissemination of the virus. The CD8 count may remain markedly elevated for many months after the patient recovers. Other infectious diseases that may cause lymphocytosis include toxoplasmosis, in which CD8 T cells are selectively increased, and pertussis, in which all subsets are increased. However, in many infections the blood lymphocyte count remains within normal limits.
http://www.sydpath.stvincents.com.au/tests/ImmunoFrames/lymphocytosis.htm

Im guessing the results could be different with multiple infections. Also of interest is that australian research out of griffith university have found cd8 t cell function is low in the cfs/me study they did. So maybe its similar to the nk cell numbers being normal but their function is low, plus im sure there are alot of variables in between.

Sorry it doesnt really answer your question but its food for thought??
 

Daffodil

Senior Member
Messages
5,875
I always have high CD8 and my specialist says this means virus. however, I test negative for all viruses. deep down, I still always suspect there is an undiscovered virus......or maybe it could mean HERV expression??
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
In my early ME years, a doctor thought at one point I had hepatitis due to my blood tests, turned out I didnt thou... my test results just improved.
 

Fuzzyhead

Senior Member
Messages
372
I have been tested for all the other hepatitis but they were negative. I think autoimmune hepatitis is different though.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
I wouldn't hurry to make biopsy if I were you ..., make another test after a month or two.

I agree. A test from 18 months ago is ancient history now. Liver function may now be entirely normal and liver biopsy is not without risks. Do you have any idea of the ANA titre on Hep2 cells? A positive does not mean much but I high titre does. The EBV sounds normal.
 

andre79

Senior Member
Messages
122
We have elevated liver enzymes as a matter of course. Unless they are very high I wonder if a biopsy is necessary. The liver is stressed in ME quite apart from other issues.

I think that raised liver enzymes in ME could be because the high amount of supplements and medicines we take. There was a point i was taking close to 30 different pills a day. Now i have reduced them to the minimum. Anything that is not strictly necessary is out.