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Author Topic: Elevated liver enzymes on Efavirenz (Atripla)  (Read 7575 times)

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Offline lmdo

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  • 35 years old
Elevated liver enzymes on Efavirenz (Atripla)
« on: October 14, 2010, 06:37:54 am »
Hi,

My partner has been pos for 9 years now and is on Atripla, has his CD4 at over 500 now! But liver enzymes are elevated. The GP says that this is not uncommon due to the efavirenz in Atripla. They have been elevated for around a year now, are about double "normal" levels.
Hep C testing is negative, but he has decided to do a more in-depth Hep C test to be sure.

Anyone else had raised liver enzymes on Atripla and NOT Hep C?

Offline eric48

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Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #1 on: October 14, 2010, 10:03:41 am »
Hi,

They check mine so I had asked a few questions to docs about it.

Levels are considered abnormal not when they are somewhat over the normal range but when they are multiple times the normal range (and I think that the multiple he gave me was actually quite high, I forgot, and certainly not 2...) So , while out of range his numbers are not Abnormal. Close surveillance may be needed, though. Cheers

Eric
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline lmdo

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  • 35 years old
Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #2 on: October 14, 2010, 05:14:28 pm »
Thanks Eric.

It will be a difficult wait until we get the results. 1 - 2 weeks

And after unprotected sex I think there can be a wait of up to 6 months sometimes! His liver is not behaving. But it is only double the normal enzyme levels - I know they get concerned once they get up to 5 or 6 times normal levels.

Offline eric48

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Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #3 on: October 14, 2010, 06:40:43 pm »
Well ... HVC + HIV would not be too good news, especially since HAART can be tough on the liver...

From what I read here Atripla is one of the softest for the liver...

are you saying that your partner is in fear that he may have got HVC from unprotected sex (here I assume you are also meaning with someone whose VHC status was unknown to him, which, seems to imply that it was not with you) ?

and are you yourself in fear that, as a ricochet, you might have been infected ?

I am quite interested in the VHC matter because there is one thing I do not understand, which is the folllowing. (and I am scared of bringing home any more nasties...)

My doc said VHC is NOT sexually transmitted (or if so, very rarely, I suppose), then , how happen it is so prevalent amoung HIVERs and the G community ? If not sexually transmitted then how come ?

On the up side, his liver is not going fail him within these 1-2 weeks you have to wait for the lab results

Cheer him up ! Eric
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline phildinftlaudy

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  • sweet Ann what you think babe...
Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #4 on: October 14, 2010, 06:58:28 pm »
Sorry to hear about the liver numbers ---
I'm on Atripla - but haven't had any problems with liver counts so far.
I had Hep A back in 2001 and acute Hep B in 2003 (which went away)
When I had the Hep A I was in the hospital for 8 days cause the liver counts were about 15 times normal --- and I definitely felt like shit.

Hopefully, your partner will be alright and the numbers will come down.
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Miss Philicia

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Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #5 on: October 14, 2010, 07:43:52 pm »

My doc said VHC is NOT sexually transmitted (or if so, very rarely, I suppose), then , how happen it is so prevalent amoung HIVERs and the G community ? If not sexually transmitted then how come ?

Off the top of my head I'd suggest fisting (not "sexual" how you were thinking, but it can cause blood-to-blood transmission) or, even more likely IMO, intranasal sharing during party time, like snorting coke, meth, etc. and of course needle sharing.
"I’ve slept with enough men to know that I’m not gay"

Offline lmdo

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  • 35 years old
Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #6 on: October 14, 2010, 10:57:37 pm »
Well Phillicia yes that is what they are saying - mainly the risk is through fisting, rough sex, amyl nitrate etc. This particular instance was what I would class as definitely a risk but not in those categories.

What the current evidence says is that if you are pos there is a risk of picking up Hep C from those sexual activities and drug taking can make it worse. But I don't think the message is out there about how there is a risk of catching this if you are pos. Yes it is hard to catch if you are neg from sex as it is only from blood-blood but if you are pos there is a definite risk.

His liver numbers have been up for over a year however Hep C testing is negative. They are doing a more "in-depth" test looking for Hep c - maybe as he has been on HAART that has made it harder to detect Hep C IF it were present on the normal test (antibodies). They are also looking for cytomegalovirus I think for a possible cause. If these are clear then they think it is a reaction to the meds. I pray this is the result. Waiting is horrible.

There are quite a few gay people out there who are co-infected with Hep C and HIV and it would be interesting to hear how they think they caught it - it sounds like the doctors are still not unified in their message about transmission. My T cells were only 220 at this time so I would be at risk of catching it - I won't relax until I get a good result anyways and have definitely had a big scare and will not be risking anything like this again.!

Offline Hellraiser

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Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #7 on: October 14, 2010, 10:58:59 pm »
Well Phillicia yes that is what they are saying - mainly the risk is through fisting, rough sex, amyl nitrate etc.

Come again?  How exactly do poppers increase your risk for disease transmission?

Offline lmdo

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  • 35 years old
Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #8 on: October 15, 2010, 12:09:41 am »
Maybe vasodilation? not sure. Maybe having more vigorous sex? Able to be fisted harder? More bleeding/ thin blood?

Offline lmdo

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Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #9 on: October 15, 2010, 12:12:03 am »
Actually not sure that is accurate of me to say amyl nitrate. Sorry.

But there is certainly confusion over how Hep C can be transmitted sexually between pos people.

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: Elevated liver enzymes on Efavirenz (Atripla)
« Reply #10 on: October 15, 2010, 12:22:45 am »
I knew about using latex gloves for fisting (not that I'm into that) and not sharing inhalant utensils a good decade ago.  It's prudent for people doing such activities to bring it up with their doctor and have a discussion, which is why everyone should have a doctor that they're comfortable enough with to have such a discussion.
"I’ve slept with enough men to know that I’m not gay"

 


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