my brother dx. 2-20, started on 3 antivirals 2-24(epivir 150 bid, zerit 40 bid, and unknown) hosp.3-9 dx. with mac, taken off antivirals,restarted on unknown regime again 3-15 or 16. now with increasing bili,enlarged liver, no abd. pain,nausea,poor, appetite. could a short regime of these antivirals cause such toxic effect to liver? thanks kathy lawrence R.N.

Generally not tough sometimes nevirapin can cause liver problems. Often if one has MAC there can be some hepatobiliary problems which might flare further due to the immune reconstitution seen with the antiretrovirlas (a paradoxical bad effect of a good treatment). Often patients may also have hepatitis B or C or fatty liver which may also make the liver more vulnerable to problems. KH