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Liver enzymes and symptoms
Dec 21, 2003

Still find your and Dr, Pierone's responses to the gentleman from India to be very moving and a wonderful testament to how caring and dedicated you both are. I would imagine that one would feel very isolated being infected in India, with far fewer support systems for HIV patients.

I have a couple of questions to which I'd appreciate your answer: my ALT is now elevated, at 85 vs. upper noraml level of 40 and my LDH is above normal.

Is this a significant result and could it signify damage to the liver or just mild inflammation? What are the symptoms of liver inflammation and what tests would you do next to track into the exact cause of the elevated enzymes?

Also, 2 years after infection, my CD4 is 850 and plasma VL almost always undetectable...very occasionally, <1,000 - is this typical - yet my CD8's are very high, even 2 years later...what does this signify? Also, my B cells were most recently 220, which is low normal...could that impact my ability to make antibodies to vaccines or other infections?

Many thanks. Happy holidays!

Response from Dr. Young

Thanks for your questions and nice comments.

Your liver enzyme test is modestly elevated-- nothing of dramatic concern, but something that I'd continue to monitor, if you were my patient. Symptoms of liver inflammation usually don't occur in persons with labs like yours, but could range from nausea, to abdominal pain to jaundice.

Your HIV labs look great to me-- an elevated CD8 count is often seen in persons with chronic immune activation (like you might expect in persons with HIV). With your current CD4 and (I might add, normal) B cell levels, your ability to make antibodies to vaccines should not be significantly impaired.

Thanks for reading and happy holidays. BY



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