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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Dec 18, 2002

I am concerned about my liver. I have been HIV+ for 4 years. I am currently taking Zerit,Epivir,and Viramune. My VL is undetectable and my tcell count is around 550. According to my doctor, my liver enzymes are highly elevated. He is going to run another liver profile and we will go with the results from there. He said that since I am taking Viramune this is not an uncommon side effect. My question is how can doctors tell what level is too high when they review a patients liver profile? Also, do other drugs in the same class as Viramune cause the same side effects with the liver? I know that I need treatment for HIV but I also need my liver in order to live as well. Any suggestions on what to do?

Response from Dr. Henry

There are many causes of liver abnormalties. Common onces include viral hepatitis (A, B and C), fatty liver (steatosis), and drug toxicities (such as chronic use of high dose Tylenol). A full work up and sometimes a liver biopsy is often necessary to sort out and to make an informed recommendation. Your nevirapine and D4T are possible contributing factors but the other causes need to be ruled out before reaching that conclusion. Often a switch to a less liver irritating drug can be made after a careful review of your past treatment history. KH

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