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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Sep 29, 2004

Long history of asymptomatic HIV,treated with antivirals, undecetable viral,good T-cell counts; also co-infected with HCV,treated 3 times without success (1b genotype),now have biopsy-proven cirrhosis due to HCV. Most labs and LFTs are either normal or mildly elevated. The only out-of-range is GGT (1,000 and above) and cannot explain it. Not consuming alcohol. In addition to HIV meds. also taking antidepressant Effexor 150 mg daily, Avandia 8 mg daily and Temazepam 15 mg at bedtime for sleeping. What are the possible causes of this persistent and "stubborn" elevation of GGT, as contrasted to only mildy abnormal other LFTs? Any of the above mentioned meds? Fatty liver? Cirrhosis itself? Early type-2 diabetes (insulin resistence)? What do to abou it? Thank you.

Response from Dr. McGovern

GGT just indicates liver origin and isn't that helpful. I think that you may have increased GGT from medications and agree with the possibiity that there could be also a contribution of fatty liver on top of your cirrhosis.

I think you have done all you can for your liver for viral eradication. You may want to ask your doctor on whether he or she would consider maintenance interferon for you (low dose for a long time). However it is important to point out that we do not have data to tell us that this is the right thing to do. The trial that will answer this is now ongoing.

Keep up the good work with your HIV medications. The higher your T cells the better - not just for HIV but probably also for HCV. Dr. McGovern

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