|hiv-hepatitis b treatment
Jun 22, 2008
Hi, Barbara, thank you for your time. What treatment would you recommend for a person who is hiv undetectable, has 450 cd4, with chronic hepatitis b, also undetectable, who is taking nevirapine and combivir?
Response from Dr. McGovern
Since you have undetectable HIV RNA, HBV DNA and great CD4 counts, I am not sure you need any changes in your medications. However, I will say that the DHHS guidelines do suggest the use of Truvada as part of your HIV treatment regimen in patients with active HBV. Perhaps you did not have any detectable HBV DNA in your blood from the start. You may want to ask your doctor about that.
Another important point is that lamivudine (which is part of combivir) is an active HBV drug. However, HBV can often become resistant to lamivudine. However, resistance does not develop in someone who does not have viral replication. If you continue to take your medications well (as you are obviously doing already) then I think you should do great because you have no detectable virus.
There are some data that show that nevirapine can cause liver toxicity. But this usually occurs within about 8 weeks of starting treatment. Since you have been on these medications for a long time, it seems like you are doing well. You should have liver function testing regularly.
If you are HBsAg positive (which I suspect you still are), you should also have twice yearly AFP testing (a simple blood test) and ultrasound testing, even if your HBV DNA is suppressed.
HCV and HIV Coinfection
- Do Hiv Symptoms Include Lymph Nodes Headache Stiff Neck?
- Can People With Hiv Work Out And Lift Weights?
- What Organs Does Hepatitis Affect?
- Probability Of Hiv Transmission With Condom
- Can You Get Hiv Because You Have Small Cuts On Your Fingers?
- Would A Cbc Test Show If You Have Chlamydia
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.