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Hiv meds and elevated liver enzymes

Jan 6, 2013

I have had slightly elevated enzymes for a few years now. (AST and ALT of 50) I've been undetectable using Kaletra, viread and combivir for about 8 years. However, combivir has been part of my regimen for 20 years.

I'm wondering whether switching to a regimen which does not include NRTIs might return liver enzymes to normal range. I realize there may be no data, but do you think it is worth a try?

Response from Dr. Holodniy

I assume other causes for increased ALT and AST have been looked for (hepatitis viruses, etc). The elevation is not too bad and many experts would probably leave it alone. I don't think you need 3 NRTIs, which is what you are getting with viread and combivir. You could consider stopping the combivir and replacing it with truvada which includes viread and a cousin of 3TC in the combivir (called FTC), and get rid of the AZT.


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