A third commonly encountered GI complication of HIV and AIDS is hepatobiliary and pancreatic disease. Often these patients present with RUQ pain jaundice hepatomegaly or elevated liver function tests. Common conditions include drug induced liver disease, hepatitis, vascular disorders, mass lesions and biliary tract disease. The most common causative agents are drugs including the antivirals, anti TB medications, and sometimes over the counter medications. Additionally drugs such as trimethoprim sulfisoxazole can also cause elevation of liver function tests.
Patients often respond to removal of the offending drug.
If not hepatitis titres may show viral hepatitis as the etiologic agent. Should these evaluations prove negative, more extensive imaging tests may be helpful in elucidating a treatable cause such as an abscess. At times, untreatable conditions may be discovered that impacts the patient s overall prognosis. Further invasive tests such as liver biopsies may not be helpful in finding treatable causes of pain or elevated liver function tests.