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Love your liver
The liver is one of the most crucial and complex organs in the body. For positive people, it is especially important as it processes the drugs used to treat HIV. Without the liver acting as a medicine converter, the treatment would be useless.
The size of a kid's AFL ball, the liver is the second-largest bodily organ after the skin and weighs, on average, around 1.5kg. Arguably the hardest-working organ in the body, it performs hundreds of different functions simultaneously. As well as metabolising medication, it changes food into nutrients, creates the blood that circulates around our bodies, produces enzymes that help digest food, creates proteins that help the immune system resist infection, makes cholesterol, stores sugar, removes toxins, and also breaks down alcohol and other potentially harmful chemicals. As well, the liver is the only organ that has the ability to regenerate, making it possible for a person to donate part of their liver to someone else.
If left untreated, HIV can increase the risk of liver problems. However, most HIV-positive people on effective treatment experience no problems with their liver at all. Even so, liver function should always be regularly monitored in case health problems appear. Usually, your blood will be screened every three to six months to keep tabs on the viral load and CD4 count. This process also includes a liver function test so as to measure enzyme levels — high enzyme levels can indicate liver damage. If your HIV medication is found to cause liver damage (a condition known as ‘hepatotoxicity’), your doctor may suggest switching the treatment combination you’re on (although this may not be an option for everyone).
People with HIV are also routinely tested for hepatitis. Vaccines exist for hep A and B. As for hepatitis C, the virus can be more severe in people with HIV and can progress more rapidly if left untreated. Hepatitis C can be sexually transmitted, particularly among gay men. Risk factors include fisting, drug use and condomless sex. The good news is that, if contracted, hep C can be easily treated with little-to-no side effects and a high cure rate.
Learn to love your liver, as a healthy liver is important for our overall health. Because the liver processes nutrients from the food we eat, one of the best ways to keep the liver in good condition is through healthy eating. Focus on natural foods, and reduce fat in your diet as it puts stress on the liver. Concentrate, instead, on ‘good’ fats found in avocados, fish, nuts and seeds. The best sources of proteins are plant-based foods such as beans, legumes and lentils. Large amounts of fluids (alcohol excluded) are also good for the liver, especially water — aim to consume at least eight glasses a day. Regular exercise is also beneficial to liver health as obesity is linked to fatty liver disease.
High cholesterol, diabetes and heart disease can also contribute to non-alcoholic fatty liver disease. Affecting one in ten Australians, it’s one of the most common causes of liver problems. Fat builds up in liver cells, causing abnormal liver function and inflammation, which can lead to liver scarring (cirrhosis). Heavy and sustained alcohol consumption can lead to cirrhosis as well; so, too, overindulgence of recreational drugs. Unchecked, cirrhosis can have serious health implications.
Oral contraceptives can also cause fatty liver tumours and should not be used by women who have a history of these non-cancerous growths. Some liver problems occur during pregnancy or affect women more often than men, including gallstones and bile duct damage.
If your liver isn’t working effectively you may experience symptoms such as fatigue (the most common), nausea, vomiting, decreased appetite, brown urine, and a yellowing of the eyes (jaundice). If you have any of these symptoms it is important you contact your healthcare provider. However, often there are no signs of liver damage until it reaches a late stage, which is why it’s important to have regular blood tests that can detect liver problems before they arise.