Based on the information you've shared, it is not possible to conclude that you have cirrhosis. A persistently elevated ALT and AST for 5 years indicates ongoing
liver injury, but normal FibroScan in the past suggests that significant fibrosis was not present at that time. Liver disease can progress over time, so a repeat evaluation is needed rather than assuming cirrhosis.
An elevated bilirubin means you have hyperbilirubinemia. If the bilirubin is high enough (usually >2–3 mg/dL), it can cause clinical jaundice (yellowing of the eyes and skin). The laboratory value alone should be interpreted along with symptoms and examination.
The fluctuation in your platelet count (268,000 → 148,000 → 152,000/µL) is not diagnostic of cirrhosis, especially since your current platelet count is within the normal range. A persistently falling platelet count together with splenomegaly and imaging evidence would raise more concern for portal hypertension.
Since your ALT, AST, and bilirubin are now elevated, you should be evaluated for the cause of this flare. Common possibilities include:
Fatty liver disease (MASLD/NAFLD)
Autoimmune hepatitis
Drug- or herbal-induced liver injury
Alcohol-related liver disease (if applicable)
Viral hepatitis (repeat testing if clinically indicated)
Less common metabolic liver diseases
Next Steps
I recommend consulting a gastroenterologist/hepatologist. You may need:
Repeat
liver function tests (including direct/indirect bilirubin, ALP, GGT)
PT/INR and serum
albumin (to assess liver synthetic function)
Complete blood count
Abdominal ultrasound with portal vein and spleen assessment
Repeat FibroScan if the previous one was done several years ago
Further tests based on your doctor's assessment (e.g., autoimmune markers, iron studies, etc.)