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HIV positive and Hepatitis B or C concern
Oct 20, 2006

My friend has taken D4T40,3TC and NVP for four months,now his ALT increased from 76 to 195.Does he need to change the regime as It is the concerning of Hepatitis B?

Response from Dr. McGovern

There are three main possibilities: 1. It is possible that nevirapine may be causing some irritation of the liver - what we call "drug-induce liver injury" or "hepatotoxicity".

2. There is a good immune response to the HIV regimen and the restored T cells are "fighting" the Hepatitis B virus.

3. The hepatitis B virus has become resistant to 3TC and is breaking through.

I would start by closely monitoring the liver function tests, getting a PT/PTT, and checking Hepatitis B serologies and HBV DNA - a measure of viral load.



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