What causes elevated ALT and AST levels during chemotherapy, and what should be done?

ALT and AST are commonly known as transaminases. Elevated transaminase levels during chemotherapy may be caused by drug side effects, liver cell damage, hepatitis B virus infection, etc. Patients should promptly go to the hospital for examination and receive targeted treatment under a doctor's guidance. Specific analyses are as follows:

1. Drug Side Effects

Most chemotherapy drugs contain certain amounts of toxic chemical substances. Long-term use may damage liver cells, especially proliferating liver cells. Since transaminases are normally present in liver cells, prolonged chemotherapy can lead to elevated transaminase levels. Patients can be treated with polyene phosphatidylcholine injection or tiopronin injection under medical supervision.

2. Liver Cell Damage

Chemotherapy is primarily a method that uses chemotherapeutic agents to kill cancer cells. An increase in transaminase levels during chemotherapy indicates drug-induced liver injury. This is a common side effect of chemotherapy, mainly caused by damage to liver cells from chemotherapeutic agents. If transaminase levels are only slightly elevated, hepatoprotective medications may be added.

3. Hepatitis B Virus Infection

If a patient was already infected with hepatitis B virus before chemotherapy, the virus might have been suppressed due to strong immunity. During chemotherapy, however, the body's immune system weakens, reactivating the hepatitis B virus and enabling it to replicate extensively, leading to liver cell damage and consequently elevated transaminase levels. Patients need to take entecavir dispersible tablets, compound glycyrrhizin tablets, or diammonium glycyrrhizinate enteric-coated capsules as prescribed by their doctors.

In addition to the above factors, elevated transaminases could also result from blood toxicity, worsening of the underlying condition, liver cancer, etc. It is recommended to seek timely medical attention at a hospital, confirm the diagnosis, and then proceed with appropriate treatment.