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Worried about liver toxicity
Jan 8, 2001

I have been on Combivar/Viramune for the past year now. My viral load is below 50 and my tcell count is 500. Recently I have been hearing a lot a negative concern regarding nevirapine and how it cause liver damage. This has me very concerned and scared. Could you give me some insight on this matter. And also what would be the risk if I change from this regiment to another one. I am not resistant to any meds.

Response from Dr. Henry

You might have some increased risk if you have preexisting liver problems (hepatitis B/C/alcohol induced cirrhosis). Avoiding those confounding variables (and others such as high doses of Tylenol) are important considerations. If you do not suffer from any of those problems you are at low risk to have a liver problem develop. I would simply monitor your liver enzymes every 3 months on the stable regimen and make sure you have been vaccinated for Hep A/B and protect yourself against hepatitis C and excessive use of liver toxins. Other regimens often have their own problems so the one you are on has a good safety profile overall with the caveats mentioned above. KH

Keith Henry, M.D.

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