BRIAN BOYLE, MD: And that's probably most common. But there can also be, in some patients, some symptoms. For example, nausea, vomiting, fatigue, malaise, diarrhea, subtle changes in skin color or in the color of the whites of the patient's eyes.
ANNOUNCER: Just as there is a range of possible symptoms HIV medicines can cause a range of liver problems.
BRIAN BOYLE, MD: Some can lead to very mild elevations in the transaminases, indicators of very mild inflammation, which is not uncommon. Other drugs can lead to relatively severe problems and severe liver damage that actually, in some cases, has resulted in liver transplantation, because the liver's been damaged so badly.
ANNOUNCER: The types of problems that can occur depend on the particular HIV medicine.
EDWIN DeJESUS, MD: The nucleosides or NRTIs can cause an enlargement of the liver, and a fatty infiltration in the liver called steatosis. Those patient also, in some severe cases, have developed what we call lactic acidosis.
BRIAN BOYLE, MD: The nonnucleosides can also cause damage to the liver. You may see an acute elevation in the transaminases. And, in fact, some have had to have liver transplants or died as a result of being treated.
EDWIN DeJESUS, MD: Protease inhibitors are also significantly associated with increase in the AST and the ALT. But the problem does not appears to be severe and, for the most part, it remains either transient or remains mild to moderate and does not lead to the discontinuation of therapy.
