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Alkaline phosphatasis (AP) still climbing up
Dec 7, 2011

Dear Dr. henry: I wrote to you about six months ago, concerned about my AP levels. By that time I had 130 U/L. Other Liver/kidney tests were normal. I took another test on last friday and my AP is now 166 U/L. The remaing tests are still normal. I take efavirenz, lamivudine and tenofovir. I am in Haart therapy since 2001 and this is my second regimen (taking it for seven years - excepting tenofovir, about a year - replacing estavudine). I also take a drug to treat bipolar disorder (Trileptal) twice a day (900 mg). I am a 47 years old "heathy" HIV positive man who works out (three times a week) and practice judo (also three times a week). Should I be concerned about this new AP result? Best wishes, Sérgio

Response from Dr. Henry

Modest alk phosphatase increases are often of no clinical significance though can signal liver disease, bone problems, hormone problems (ie thyroid, parathyroid, adrenal) and many other conditions so a general health evaluation and following levels is recommended. Trileptal can increase some livere enzymes-your HIV regimen would rarely be the direct cause. KH

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