ABSTRACT
INTRODUCTION Only a few years ago, liver complications of human immunodeficiency virus (HIV) infection were almost incidental to patient survival. Now, with potent antiretroviral regimens and better prevention and treatment of opportunistic infections, HIV-infected patients are living longer and liver-related complications have become a major source of morbidity and mortality. Because hepatocytes are CD4-negative, primary HIV infection has little effect on the liver, but the shared risk factors of homosexuality and parenteral drug use make viral hepatitis B and C common in this patient population. Highly active antiretroviral therapy (HAART) has become standard care for HIV-infected patients; it has important hepatotoxicity in addition to all the other potential hepatotoxins to which these patients are exposed. Chronic viral hepatitis and drug hepatotoxicity are now the major liver complications in these patients.
