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Main Forums => Living With HIV => Topic started by: survivor703 on October 27, 2012, 09:03:04 am

Title: Treating a fungal infection with high liver enzymes?
Post by: survivor703 on October 27, 2012, 09:03:04 am
Hello all....

I'm back again with another problem. They just won't stop coming. so as I mentioned in my previous post, "disease progession?" I had some spots down there, so it turns out those spots are likely tinea cruris from my atheletes foot... so the doctor prescribed a cream, ciclopirox for the toes, and he prescribed a pill, ketoconazole 200 mg 2x's daily, for the genital area.

He told me that he wanted to check my liver enzymes before I started taking the antifungal pill... these are the results for the liver enzymes. NOTE: I don't take any drugs now except for multivitamins and fish oil.

Test                  My Result         Standard Range
TOTAL PROTEIN   9.1                 6.3-8.3
ALT                   57                   0-50
AST                   58                 9-53

**bilirubin and albumin were within "normal" range.

So after getting the results, the doctor emails me and says, your levels are elevated, so maybe you shouldn't take the drug. perhaps this is due to your hepatitis? He thought I had hep B because I had the antibody present. But when I went to my ID doctor, and I told him what my general doctor said, he laughed... he told me you HAD Hep B in the past and are now immune to it. But you don't currently have Hep B.

Anyway, so now I'm thinking about taking these pills anyway to clear up this infection. It's only for a week.

what do you guys think ?


Oh yeah, my lymphocytes are at 60% (5.27) consistently.... IDK what that's about.


yeah, I'm worried. 
Title: Re: Treating a fungal infection with high liver enzymes?
Post by: MilburnCreek on October 27, 2012, 09:43:00 am
I can tell you that my liver enzymes have been elevated my entire life...it's like the broken record I hear from docs....its never gotten worse (including after starting HAART), it just remains elevated.  That's me.  I've also heard a LOT of guys say the same (especially those who have active workout routines...hermatocrit is normally off the scale)  In my particular case, I wouldn't worry at all....

So, I guess one question you might want to answer is, have your liver enzymes always been high? Or is the current elevation a sudden or serious elevation over your normal levels?  I know anti-fungal pills are *not* guaranteed cures (they don't do crap for my athletes foot or jock itch), but they *can* be harsh on your liver.

Just some food for thought...
Title: Re: Treating a fungal infection with high liver enzymes?
Post by: survivor703 on October 27, 2012, 10:01:23 am
Quote
So, I guess one question you might want to answer is, have your liver enzymes always been high? Or is the current elevation a sudden or serious elevation over your normal levels?

Thanks for your information, this does help a lot. As for my previous results back in February when I first got diagnosed, they were about half what they are now... like around 25/30.
Title: Re: Treating a fungal infection with high liver enzymes?
Post by: Ann on October 27, 2012, 10:40:47 am
Your levels are only slightly elevated. I can't see taking antifungals for only a week creating any serious problems. You might, however, want to abstain from drinking alcohol during that week.

Make sure you give the treatment the best chance of working by keeping the affected areas clean and, importantly, dry. Always wash and thoroughly dry the area before applying cream, and always wash your hands after touching the affected areas so you're not spreading it around your body.

It may help to use a hairdryer on a cool setting to make sure the areas are completely dry before applying cream and getting dressed. Also, change any clothing that comes in direct contact with the rash every time you wash and re-apply the cream.

You might want to get some over-the-counter clotrimazole cream (marketed as Canesten) for your jock itch (the common name for fungal infections in the groin area). Alternatively, you could get tea-tree cream (don't use the oil itself) - it's usually marketed as a first-aid type cream and it has really good antibacterial and antifungal properties. You can also buy OTC antifungal powders for jock itch that will help keep the area dry in-between washes and cream applications.

I had persistent athlete's foot for years before I started hiv meds. I was able to keep the fungus down to a dull roar with creams (alternating between clotrimazole, miconazole and tea-tree), but it's only since I've been on hiv meds that it's cleared up completely. You may find you have a similar experience.
Title: Re: Treating a fungal infection with high liver enzymes?
Post by: survivor703 on October 28, 2012, 10:27:57 am
thanks Ann for the good advice..... I'm going to try that cleaning and drying approach, then apply the cream. I think I'm going to give the pills a shot anyway. I rarely drink alcohol. Crossing my fingers!

Thanks again for the info