Dr. McGovern,

Two years ago I was diagnosed with a co-infection. I responded quickly to HAART and have sustained an undetectable VL and CD4 count between 400-500. I had a liver biopsy two years ago that showed minimal inflammation. My question is how quickly could one generally progress to a higher stage of liver damage if they continued to drink two bottles of wine per week as I have done? Now it's time for another biopsy and I'm scared. I know this is risky behavior, but frankly I couldn't handle the stress of the co-infection without some type of release that the wine gave me. I'm 52 if that matters at all. Thanks so much for all you do for us on this site.

The fact that your first biopsy looked good is reassuring, but I certainly agree with your doctor that it is time for a repeat look. Yes alcohol can accelerate fibrosis, but you will soon know after the biopsy if treatment is necessary.

Having a non-detectable HIV RNA is great news along with your good T cell count. If you do need treatment for HCV, it seems like you are in a good place for that. There are also some data suggesting that HIV viral suppression helps slow down liver fibrosis progression.