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Liver Function and Anabolics
May 25, 2004

Nelson,

Hi. I am on a once daily regimen of viramune/viread and emtriva and I also take lexapro for depression and diovan for high blood pressure.

I have low testosterone and so my doc presecribed 100ccs of depo testosterone.

My question is with a HAART regimen including viramune and the injectible test I am on, I am nervous about long term toxicity to my liver.

Is there anything I can do to minimize this (milk thistle?)

What are your thoughts?

Jim

Response from Mr. Vergel

Jim:

I am assuming you mean 100 mg of testosterone a week. Replacement doses of injectable (not oral) testosterone have been found to have no effect on liver function. You may also want to try Testim, a newer topical testosterone gel that seems to absorb better than Androgel.

Although not a common side effect, liver enzyme increases can occur in some people on Viramune. Just talk to your doctor about it. I am sure he/she checks your liver function every three months or so.

There are many ways to protect the liver. Get tested for Hepatitis A,B, and C. If you are negative to A and B, get vaccinated. If you are Hep C positive, get treatment. Also, limit your consumption of alcohol and take a good antioxidant blend. Milk Thistle may be helpful but , unfortunately, we have no data on its effect on HAART induced liver dysfunction, and there are questions on whether it may have some interactions with protease inhibitors.

You are on a metabolically friendly combo. Unfortunately, we have no published data yet on how effective it is for HIV. I heard that there is a study on the east coast looking at it right now. If I was treatment naove today, I think that would be the combo I would go for, though. Hopefully the data will look as good as our expectations.

Nelson



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