Dr. Sushil Kakkar
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I just found I am HIV positive, but I am not on medication yet. My CD4/viral load count is 445 /22,500. I do have issues with my liver enzyme Aspartate aminotransferase (AST)=87, Alanine transaminase (ALT)=201, ferritin =800, but negative for hepatitis B. The doctor wants to protect my liver, so she gave me first hepatitis B vaccine. My concern is if this is the right decision because I am not on HIV medication yet and I do not want to see my viral load count increase by B vaccine. My doctor wants me to start medication for HIV, so I am planning to take Genvoya. I am scheduled for an ultrasound and fiber scan for my liver in a month. My concern is starting the medication a right decision for my situation before I know the condition of my liver. I am starting to get a feeling "do I have the right doctor for me?" I read about Genvoya and it is saying that it isnot recommended for people with severe liver impairment. I do not think I have "severe liver impairment." I need advice. Is my doctor's decision getting hepatitis B before HIV medication is the right choice? Should I justfollow my doctor and start medication?
Hello, Welcome to icliniq.com.
I think it is the right decision to vaccinate against hepatitis B because it protects you against future exposure to this virus. Hepatitis B is having the same routes of transmission as HIV (human immunodeficiency virus) vaccination. Hepatitis B does not interfere with HIV infection. A CD4 count of less than 500 is an indication to start ARV (antiretrovirals).
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Dermatology
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