Physicians are treating patients infected with human immunodeficiency virus and/or hepatitis B or hepatitis C in their practice more often. Long-term complications of this diseases are multifactorial and can be related to the virus itself or to adverse effects of antiretroviral therapy. The liver is the main organ for regulating the internal environment of a body. There is no way to compensate for the loss of a liver function. It has major influences on the flow of nutrients as well as controlling carbohydrate, protein and fat metabolism. Drugs are significant in causing liver injury. More than nine hundred drugs, herbs and toxins have been documented as being hepatotoxic in line with different risk factors. The incidences of severe hepatic injury vary among different study cohorts as well as the differences in risk factors. Patients with a co-infection of HIV and Hepatitis B or C are at a risk of getting liver injury from antiretroviral drugs because the co-infections accelerate liver injury that may lead to cirrhosis or hepatocellular carcinoma. The risk of liver damage for those with a monoinfection of HIV alone is lower than in co-infections. This review explores risk factors for hepatotoxicity, its hepatotoxic antiretroviral drugs and the mechanisms of toxicity. It is meant to highlight the hepatotoxic potential of different antiretroviral drugs currently in use by HIV infected individuals.

High-level viral replication occurs when HIV enters the body. Due to frequent mutations, the virus becomes resistant in the body and persists in memory T cells making it incurable. Lifelong therapy is then required to suppress replication of the virus in the cells. The drugs available for HIV care such as Non-nucleoside reverse transcriptase inhibitors, Protease Inhibitors, Nucleoside reverse transcriptase inhibitors, Entry and Fusion Inhibitors and Integrase inhibitors have been documented to cause adverse effects in patients. Non-nucleoside reverse transcriptase inhibitors and protease inhibitors are metabolized by the cytochrome P450 system, resulting to numerous drug-drug interactions. Adverse effects of antiretroviral therapy should be monitored frequently. Monitoring should include complete blood counts and comprehensive metabolic profiles every three to six months. Lipid profiles and urinalysis for proteinuria should be done after every year. Long-term morbidity due to antiretroviral therapy includes renal, liver, glucose, and lipid abnormalities, and bone disease as well as cardiovascular disease. With some exceptions for lipid management, these morbidities can be managed. This review aims at describing different non-hepatic adverse effects of antiretrovirals as well as factors associated with them.

Viruses whose genome is RNA are capable of quickly adapting to different conditions because their polymerases have a higher error rate during replication. Most emerging and reemerging viruses such as HIV, Influenza and Marburg belong to this group of viruses. Different factors contribute to emergence of disease:The factors, coupled with the rapidly increasing human population have led to the emergence and reemergence of viral diseases in human populations over the years. This review discusses the global trends and epidemiology of some RNA viruses over the years to try and trace the epidemics of these diseases down the years and if there can be predictive capabilities.