Why is it important for doctors to monitor for signs of possible liver damage when they're treating people with HIV therapy?
It's important that we monitor the liver because a lot of the medications that we give to our patients to treat their HIV infection can cause liver problems. Also, HIV disease and AIDS can lead to opportunistic infections that can settle in the liver and cause liver problems.
How do doctors monitor for signs of liver damage?
Inflammation of the liver and how it is functioning are monitored with simple blood tests including liver transaminases. The transaminases are enzymes that spill into the bloodstream whenever there is inflammation of the liver caused by a medication or an infection. The main transaminases are ALT and AST.
There are other ways in which we can test for the liver, such as testing its ability to filter blood and toxins from the body. For example, the coagulation test and the ammonia test can measure liver function. Other tests that measure the function of the liver include blood tests for albumin and bilirubin.
Are symptoms always present when there's liver damage?
Most of the liver inflammation that can occur with HIV treatment is actually asymptomatic, meaning it does not produce symptoms. Patients don't know that they're having a problem with their liver until their physician conducts a liver function test. So for the most part, the patient is not aware that this problem is occurring.
Depending on the type of injury that the drug is inflicting on the liver, the patient can experience fatigue and abdominal pain. They might also have yellowish coloration of the skin and the whitish part of the eye.
