The liver is one of the most important and largest organs in your body. It has been described as the body’s ‘chemical processing plant’. It plays a key role in food metabolism and digestion, in producing immune system proteins and importantly for people with HIV, in the breaking down of prescription and other drugs, and alcohol.

Older age (even without HIV) is associated with decreased liver function.

A healthy liver is important to process medicines effectively, so if your liver has been damaged by drinking too much alcohol, you are more likely to experience
side effects from HIV medications (especially if you have hepatitis).

The blood fat increases caused by some HIV medications can also be made worse by heavy drinking.

There are a number of reasons why people with HIV may be more likely to experience liver damage.

These include:

• increased use of both prescription and over-the-counter medications that can cause liver damage (especially paracetamol)
• increased incidence of hepatitis B and C
• increased levels of alcohol and other drug use

• pain in upper right abdomen or generalised abdominal pain
• fatigue

• nausea

• dark urine

• clay colored stool (faeces)
• jaundice (yellowing of the skin and white part of the eyes)