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HIV positive, elevated liver enzymes
Jan 25, 2009

I'm HIV positive since January 2008, currently not on treatment. Today during my routine blood work my liver enzyme values came back somewhat high, ALT 62, AST 47. My hbv and hcv serologies were negative as of September 2008. My doctor immediately asked if I had unprotected sexual encounters, she is worried about hepatitis infection. After I told her that the riskiest activity I did was French kissing, with possibly irritated/bleeding gums she decided there was no need to repeat the serologies. However I started worrying about possible hep c infection (I'm vaccinated against hep b) since I don't drink, take any medications or I'm not overweight. Could you interpret my results and tell me if I really would need another hep c test?

Response from Dr. McGovern

Your ALT and AST are only mildly elevated. Liver function tests can be mildly elevated from various medications.

I think your doctor is right on top of things to be asking regarding any risk behaviors so this is excellent.

I would certainly get vaccinated against hepatitis B if you have no protective surface antibodies.

I would continue to monitor your ALT and AST and if they remain elevated, and would consider an ultrasound to look for fatty liver - However, I suspect that it will not be revealing since you are not overweight. You should also have other testing for other liver diseases as well (eg, hemochromatosis - a liver disease that is relatively common in the US - but not an issue related to HIV per se).

Alcohol use and some over-the-counter drugs can sometimes cause elevated liver function tests as well. Would review any OTC you are taking with your physician.

Best regards



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