RE : High level of SGOT/SGPT

Question

Dear Doctor,

My cousin got positive HIV Nov last year. At that time, his CD4+ was below 100 and viral load was 3500. He did treatment of HAART (with following meds : Nevirapine & Lamivudine/Zidovudine). He tested viral load and CD4+ in June/2007 and got following result : Viral load : undetectable CD4+ : 239 But unluckly SGOT : 38 SGPT : 83

On end of Aug/2007, we got following result : CD4+ : 263 SGOT : 69 SGPT : 130

We believe his SGOT/SGPT are too high. And his doctor prescribe medicine to reduce his SGOT/SGPT. Last week he tested SGOT/SGPT and got following : SGOT (AST) : 127 SGPT (ALT) : 85

Our questions are

  1. Why can his SGOT/SGPT be so high like that ? How to reduce SGOT/SGPT effectively ?

  2. Does above high scale of SGOT/SGPT means that his meds (Nevirapine & Lamivudine/Zidovudine) is not suitable for his body ? Is it necessary for him to change the meds ?

We are looking forward to receiving your prompt reply.

Answer

He has had a great response to this regimen. That said, it is likely that the nevirapine is the cause of the elevated GOT and GPT. Those are not horrible results. They are about 2 times the upper limit of normal. In most people these are tolerable elevations and would probably not cause any long term damage. On the other hand if he already has liver problems (from hepatitis infection, drinking alcohol, having to take other medications that might cause liver problems) than switching the nevirapine might be indicated.