<s>[INST] Hi DocMy brother was diagnosed with Hepatitis E witChatDoctorplicated malaria a week back, his conditionis getting worse as his Bilirubin levels are constantly rising and are now at 21 and his enzymes have crossed 3000, my question is that what could be causing the constant rise inbilirubin levels ? [/INST] Hi and welcome to Chat Doctor. Thank you for your query. I am Chat Doctor, I understand your concerns and I will try to help you as much as I can. This may be sign of serious liver damage and there may be a coinfection with other hepatitis types, so it should be ruled out first. Also there may be homeostasis or hemolytic anemia and more detailed evaluation should be performed so that treatment can be started on time. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. </s>