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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Co-infection with HIV and HBV
May 12, 2004

My son has been co-infected with HIV and HBV since 1985. He began HAART in 1997--3TC + d4T + nevirapine, and, fortunately, has had no side effects. His viral load has remained undetectable, and his T-cell count has risen from just over 200 to 1100. With the exception of one brief blip, treated successfully with several supplements and milk thistle, which he continues to take, he has had no problem with the HBV. Tests showed no fatty liver. Given the concerns about nevirapine, is it wise for him to continue using it as long as it works or should he consider switching?

Response from Dr. Dieterich

The toxicity of nevirapine occurs in the first 6 weeks. If he has not had a problem yet, he very likely never will. He needs to make sure that someone is following his HBV DNA. It often mutates and becomes resistant to HBV. There are other meds to use if HBV becomes resistant to 3TC. Wish him luck! DTD

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