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Should I have a Liver biopsy
Dec 26, 2002

I have HIV and HBV. On meds for 15 months, Trizavir-Viracept. AST 13, ALT 8, ALK PHOS 68. My ID Doc just ordered HBV by PCR VL test and gave me a referral to GI Doc. With these numbers should I be asking for Liver Biopsy or ultrasound. What are the chances that I have cirrosis. Moderate to heavy drinker in the past. No Drugs.

Also, Hematology comments include Few Howell-Jolly bodies present. I don't recall seeing this before and have no idea what it means.

Response from Dr. Holodniy

Howell-jolly bodies are small pieces of DNA inside red blood cells. They are an indication that the spleen (a filtering and immune organ) is not working as well as it should (hyposplenism). These bodies could also indicate hemolysis (destruction of red blood cells) from a variety of causes. Hyposplenism can be associated with active hepatitis or HIV infection. Most GI docs would do an ultrasound first anyway. They will look at the size and consistency of the liver and should also look at the spleen. There are also other blood tests (albumin, INR, etc) that can be measured to see how well your liver is working.



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