Help with statin prescribed by doctor.

[Jackmydin]

Hi guys.

I'm currently 36 years old male and lately having issue with my liver enzymes reading 3 months ago (provably due to fungal medicine I took). At first my ID doctor scheduled me for ultrasound and hepatitis blood test, came out with hep b & c negative result. Abdominal ultrasound all OK, except for diffuse fatty liver. At first the doctor told me to change my diet and cut weight, if my liver enzymes marker is not improving, he's putting me on statin. So I took his advise and managed to cut 4-5 kgs in 3 months (82kg to 77kg).

My latest two months blood test for liver is fine already, but my doctor still insist to put me on statin. I read online statin is use to reduce liver enzymes, and my case is only an one time incident due to fungal medication. When I stopped the fungal medication, my levels are back to normal.

I questioned my doctor his decision for statin, and he says my cd4 is dropping and he's doing this to prevent me from any opportunistic infection. Right now my next cd4 bloodwork is on Sept, and I'm thinking of asking the doctor to wait for my cd4 first before I start statin.

Mostly I'm just curious, how much help of this statin would do for me if my liver enzymes is already back to normal.

my ast/ALT level:

1/3/23 - 100/156
14/4/23 - 63/86
19/4/23 - 46/58
12/7/23 - 38/41

[harleymc]

We have a much higher cardiac risk than people who don't have HIV.

I'm not sure why a fatty liver is a concern, maybe that indicates excess fats and cholesterol in the bl{d? I'm not a doctor, just guessing.

I take my statin at night and my Bictarvy in the morning. Not too difficult.

[Jackmydin]

Any obvious side effects? I read online it usually causes muscle pain and low libido

Anyway, I'm getting lab test for my chlorestrol. Just weird why the doctor would prescribe statin without checking my hdl/ldl level. My last chlorestrol test is done last year. 80 for hdl, 96 for ldl,

[harleymc]

No obvious side effects for.me.

But that can vary from person to person.

Good luck

[leatherman]

low libido

that's an uncommon statin side effect but is more likely a side effect from blood pressure meds.

I questioned my doctor his decision for statin, and he says my cd4 is dropping and he's doing this to prevent me from any opportunistic infection.

statins have nothing to do with cd4s. Matter of fact, short of living healthier and taking ARVs there's nothing to do to raise cd4s. Bactrim/Septra are used to prevent PCP pneumonia when cd4s<200. There aren't any other meds to prevent other OIs.

I would point out that while your cd4s have dropped some

4/8/21	373	11.42%
23/2/22	346	12%
1/3/23	215	15.29%

the percentage of cd4 has been climbing. The actual amount of cd4s over those three tests has only changed by 158pts. I point that out because cd4s can change up to 100pts a day. However looking at the percentage number, which is a more "steady" number, it's creeping upwards.

the best thing to do about this confusion is to simply talk to your doctor again. You pay for their medical advice so take advantage of that service. Make them explain just what's their thought processes are for a statin.

Actually we're having a similar issue here at my house. My husband's cd4s have been dropping over the last two years. Interesting, like you, his cd4 percentage has been climbing. His have climbed from 17% to 29.75%. Even with lower cd4s his percentage is just .25% from "normal". Weirdly my cd4s have been climbing in the same two years and I've gone from 365 to 784. After 15 yrs of <300 and another 10 yrs <400, I sometimes have to wonder if something is just wonky at the lab. I don't trust my insanely high numbers or my husband's low numbers. I guess we'll just have to see what the clinic finds out from the lab and what happens in the future.

HIV is weird sometimes. LOL

[Jackmydin]

Well it's a free health care system, so everytime I question alot the docs just seems annoyed (maybe there's alot of patients behind me and they don't wanna waste much time on answering) but I don't blame them.

Currently my cd4 is a little above 200, and my next bloodwork is next month. Hopefully I'll be back to undetectable.

BTW I just got my chlorestrol checked this morning, everything seems fine, except lower hdl and border ldl.

Hdl =1.41 [>1.50]
Ldl = 2.6 [ <2.6]

Guess I'll try to eat clean and exercise more often first to deal with my fatty liver. Starting statin now just seems too early 🤔