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What Does the Liver Do?
Your liver is one of your largest and most important organs. It is the ultimate "multitasker," storing important nutrients and producing chemicals your body needs to stay healthy. It also helps your body digest the food you eat, and breaks down (metabolizes) many meds, plus harmful substances like alcohol and other toxic chemicals.
Damage to the liver can occur in people living with HIV. Some antiretrovirals can be toxic to the liver. There are also viral infections that can cause hepatitis-an inflamed liver-that can potentially lead to serious problems.
Can HIV Medications Hurt My Liver?
Though antiretrovirals usually do a remarkable job of fighting HIV and keeping you healthy, they can sometimes have toxic effects on the liver. Called "hepatotoxicity," liver damage usually occurs slowly over time, either by directly damaging liver cells-as seen occasionally with protease inhibitors-or by increasing a cellular waste product called lactic acid-as sometimes happens with nucleoside reverse transcriptase inhibitors. Some hepatoxic effects happen more rapidly and are due to an allergic reaction that inflames the liver. This happens most often with the drugs nevirapine (Viramune) or abacavir (found in Ziagen, Epzicom and Trizivir). A simple blood test to check CD4 cell counts in the case of Viramune (it should not be used by people with high CD4 cell counts), or a hypersensitivity test for Ziagen, allows doctors to use both drugs safely in most people.
If you're taking HIV medications, monitor your liver enzymes with your health care provider using simple blood tests. Hepatotoxicity is usually reversible, once the offending drug is discontinued or changed.
What Is Hepatitis?
Hepatitis is the scientific term for an inflamed, or diseased, liver. It can be caused by the toxic effect of some medications or other drugs, such as heavy alcohol use, as well as by infections caused by viruses (viral hepatitis).
What Should I Know About Viral Hepatitis?
The three most common strains of viral hepatitis in the United States are:
- Hepatitis A virus (HAV). Usually spread by putting something in the mouth-even though it might look clean-that has been contaminated with feces from a person with hepatitis A. Unsafe and unsanitary food preparation are common sources of infection. HAV is also transmitted by oral/anal sex. HAV typically causes a moderate but brief period of illness before being cleared by the body. People living with HIV who have not already been exposed to HAV should be vaccinated against the virus.
- Hepatitis B virus (HBV). Most commonly transmitted by sex, contact with blood, or via childbirth, HBV can become a serious and chronic infection in about 25% of people with HIV whom it infects. HBV slowly damages the liver and can lead to liver failure and liver cancer. People with chronic HBV usually can't be cured, but they can be treated. Three of the drugs used to treat HIV may also used to treat HBV. People living with HIV who are not infected with HBV should be vaccinated against the virus.
- Hepatitis C virus (HCV). Usually transmitted through contact with infected blood, either through sharing needles or childbirth, HCV can also be transmitted sexually. Over the course of several years, HCV can lead to severe liver damage. In people also infected with HIV, the course of disease can be faster. There are treatments that appear to cure the disease in roughly one third of people who are coinfected with both HIV and HCV. There is currently no vaccine to protect against HCV. Latinos have higher prevalence rates for HCV, are infected at an earlier age, and are more likely to be HIV-coinfected.
Quick Tips
You've got one liver to love-protect it.
- Vaccinate: If you've tested negative for HAV and/or HBV, vaccinate against both infections.
- Play it safe: Follow safer sex-oral, vaginal and anal-and safer injecting practices to avoid viral hepatitis.
- Test regularly: Make sure that your doctor performs a "chem screen" every three to six months to check liver function.
- Know the source: Eat at restaurants where cleanliness is a priority. This is especially important for uncooked foods.
- Easy does it: Heavy drinking can damage the liver, and people with HBV or HCV may need to avoid alcohol altogether.
- Eat Well: A good diet can help liver cells damaged by hepatitis to regenerate, forming new liver cells.
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