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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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Nov 3, 2006

I read A letter from a hiv psoitive person who states viamune is the worse medication a person could be on who has hepc. is there any truth to this? my husband who has hepc and didn't respond to interferon theopy is on viamune. his liver disease is advance.

Response from Dr. McGovern

Viramune (nevirapine) is a non-nucleoside reverse transcriptase inhibitor of HIV. It is a very effective drug against HIV.

There are reports of an increased incidence of hepatotoxicity with nevirapine compared to some other HIV medications. However, if your husband has been on this medication for quite some time and is tolerating it, I would not be particularly worried. I would get regular monitoring of liver function tests however. I would also be aware of the symptoms of drug induce liver injury, such as nausea, vomiting, right upper quadrant pain, lack of appetite, jaundice.

There is one paper that suggests that Viramune may be associated with increasing scarring in the liver. However, it is a very small study and no other paper has verified these results.

You and your husband may want to discuss these issues further with your physician, but I wouldn't stop any medications without discussing this further. I would also make sure other immunizations are up to date (eg, hepatitis A and B, pneumococcus). Also avoid alcohol which is the biggest offender.

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