My partner who was dx hiv 4 yrs ago was recently admitted for cholecystitis..later found out it had infected his peritoneal space and his liver took a direct hit and was dx'd with end stage liver dz. I am concerned with a number of issues but mostly with his Hiv and now cirrhosis does this cut his life expectancy even more? He was quite wild when younger but now is 52 and has settled dramatically over the last few years. Also is his constant exhaustion normal with his recent dx of end stage liver dz. I will see his physician the end of the month. Can you suggest any additional questions to help me ? Thanks, Tim

Hello and thanks for posting.

It is important to differentiate between a diagnosis of cirrhosis and end stage liver disease does because many they are not necessarily the same. The natural history of liver cirrhosis is to progress towards liver failure over a variable period and this comes with a negative impact on life expectancy.

The first question is whether his liver disease is caused by hepatitis B (as with your partner) or some other condition. Hepatitis C, alcohol exposure, or a combination of factors may also influence the course. There have been advances in treatment of Hepatitis B which can slow down progression of disease. Medications like adefovir, tenofovir, lamivudine (3TC) and emtricitabine (FTC) can often bring hepatitis B viral levels under control.

Liver transplantation is now being performed on HIV infected patients with liver failure because of the improved overall prognosis related to HAART. But sometimes after the liver takes a hit (especially after a recent infection like cholecystitis), there is a degree of liver recovery. It will be important to follow up with a liver specialist to get a better sense of what options are available.