ABSTRACT
Viral infections still pose a considerable threat to the human population, because they can
spread rapidly and only a few drugs with antiviral activity are as yet available. The recent
development of multiple effective antiretroviral drugs to treat HIV infection, however, has
illustrated the impressive therapeutic potential antiviral drugs can display. Now, the study
of liver function during antiviral therapy of HIV-infected patients, especially those with
concurrent hepatitis B and C coinfection, has become an emerging issue. The availability of
highly active antiretroviral therapy (HAART) has led to a marked reduction of opportunistic
diseases including hepatobiliary complications associated with severe immunodeficiency.
However, short-and long-term liver toxicities have been reported for virtually each single
antiretroviral agent and may add to the liver damage caused by the frequently underlying
chronic hepatitis B and/or hepatitis C (1-3). Novel and potent pharmaceutical regimens are
also available to effectively treat chronic hepatitis B and C, e.g., polyethylene glycol-coupled
recombinant interferons and antiviral drugs directly interfering with viral replication such as
ribavirin, lamivudine, adefovir, tenofovir, and entecavir. Still more antiviral drugs with activity
against HIV or hepatitis B and C are expected to be licensed in the near future. The extensive
and prolonged use of these drugs has the potential for interactions andmay further increase the
risk of liver toxicity (3-5).