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Side Effects of HIV Medicines

HIV and Hepatotoxicity

(Last updated 11/15/2016; last reviewed 11/15/2016)

Key Points

  • Hepatotoxicity means damage to the liver caused by a medicine, chemical, or herbal or dietary supplement. Hepatotoxicity can be a side effect of many different HIV medicines. 
  • People who are taking HIV medicines should know about this potential side effect of some HIV medicines. In some cases, liver damage can be life-threatening.  
  • Signs of damage to the liver may include stomach pain, unusual tiredness, nausea (upset stomach), dark-colored urine, light or clay-colored stools, jaundice (yellow skin and eyes), loss of appetite, and fever. If you are taking HIV medicines and have any of the symptoms listed, contact your health care provider immediately.
  • Management of hepatotoxicity due to HIV medicines varies depending on the extent of damage to the liver. Sometimes it’s necessary to stop taking the HIV medicine that is causing the hepatotoxicity.

What is hepatotoxicity?

Hepatotoxicity means damage to the liver caused by a medicine, chemical, or herbal or dietary supplement. Hepatotoxicity can be a side effect of many different HIV medicines. 

People taking HIV medicines should know about this potential side effect of some HIV medicines. In some cases, damage to the liver can be life-threatening. Learn more about the potential side effects of HIV medicines in the AIDSinfo Drug Database.

Are there other factors that can increase the risk of hepatotoxicity?

The following factors may increase the risk of hepatotoxicity due to HIV medicines:

  • Being over 50 years of age
  • Also having hepatitis B and/or hepatitis C infection 
  • Taking other medicines that can cause liver damage
  • Alcohol or drug abuse
  • Obesity
  • Past history of liver damage

What are the symptoms of hepatotoxicity?

Symptoms of hepatotoxicity include the following:

  • Stomach pain
  • Nausea (upset stomach)
  • Unusual tiredness 
  • Dark-colored urine
  • Light or clay-colored stools
  • Jaundice (yellow skin and eyes)
  • Loss of appetite
  • Fever

If you are taking HIV medicines and have any of these symptoms, contact your health care provider immediately. However, do NOT cut down on, skip, or stop taking your HIV medicines unless your health care provider tells you to.

How is hepatotoxicity detected?

Liver function tests (LFTs) are a group of blood tests used to check for damage to the liver. Before treatment with HIV medicines begins, LFTs are done to check for already-existing liver damage. The risk of hepatotoxicity is greater in people who have liver damage before they start taking HIV medicines. If LFT results show pre-existing liver damage, HIV medicines that may cause hepatotoxicity should be avoided. There are many other HIV medicines available to use instead.

Once treatment with HIV medicines begins, health care providers use LFTs to monitor for signs of hepatotoxicity.

How is hepatotoxicity managed?

Management of hepatotoxicity due to HIV medicines varies depending on the extent of damage to the liver. Sometimes it’s necessary to stop taking the HIV medicine that is causing the hepatotoxicity. However, the decision to stop taking an HIV medicine should only be done in consultation with a health care provider. If you are taking HIV medicines, do NOT cut down on, skip, or stop taking your HIV medicines unless your health care provider tells you to.

If you are taking or plan to take HIV medicines, talk to your health care provider about the risk of hepatotoxicity. 

This fact sheet is based on information from the following sources: