Shandong Zhanhua Yonghao pharmaceutical & Tech Co.,Ltd

The liver is one of the largest and most important organs in the human body. It processes almost everything you eat, drink, breathe and absorb through the skin. It breaks down harmful substances, such as alcohol, and it converts many drugs into forms that are easier for the body to use. It also provides energy from food, stores nutrients, produces blood proteins and acts as a filter to remove harmful toxins, microorganisms and waste products. A healthy liver is essential to a healthy life!

People with HIV often have problems that affect the liver. HIV can infect liver cells, and the virus can cause persistent inflammation—even when the viral load is undetectable—that can harm organs throughout the body.

Some medications can cause liver damage, including certain HIV meds. Alcohol, recreational or street drugs, some supplements and herbal remedies and toxic chemicals in the environmental can also harm the liver.

Compared with HIV-negative individuals, people living with HIV are at higher risk for viral hepatitis (hepatitis A, B and C), alcoholic liver disease, and non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH). Over time, hepatitis B or C, heavy alcohol use, fatty liver disease and other causes of liver damage can lead to cirrhosis, liver cancer and the need for a liver transplant.

Fortunately, there are many things you can do to keep your liver healthy, including eating a balanced diet, maintaining a healthy weight, getting enough exercise, limiting consumption of alcohol and recreational drugs, getting vaccinated against hepatitis A and B and getting treatment for hepatitis C.

What are the signs of liver problems?

Regardless of the cause, liver conditions have many signs and symptoms in common, including:

Feeling tired and rundown (fatigue)
Fever (with viral hepatitis)
Loss of appetite
Weight loss
Nausea
Vomiting
Abdominal pain, especially in the upper right side
Muscle and joint pain
Itchiness (pruritus)
Yellowing of the skin and whites of the eyes (jaundice)
Dark urine
Pale-colored stools.

Symptoms may occur during acute hepatitis, soon after infection with hepatitis A, B or C. But many people with early-stage liver problems have no symptoms and feel fine, or they may have mild symptoms that they mistake for the flu. Symptoms can worsen as liver damage progresses. However, many people with hepatitis B or C or fatty liver disease take years to develop symptoms, and some never do.

Changes in liver enzyme levels in the blood can be an early sign of trouble. These include ALT (alanine aminotransferase), AST (aspartate aminotransferase), alkaline phosphatase and bilirubin. Elevated ALT and AST are signs of liver inflammation. These liver function tests are usually included in standard “chem screens” that may be done when you have blood drawn to check your viral load and CD4 count.

What are the complications of liver damage?

Hepatitis B or C, fatty liver disease, heavy alcohol use, ongoing drug toxicity and other causes of liver injury can trigger liver inflammation. This can lead to the buildup of scar tissue, known as fibrosis, as the liver tries to repair itself. Over time—many years or even decades—this can progress to cirrhosis, hepatocellular carcinoma (the most common type of liver cancer), end-stage liver failure and the need for a liver transplant.

In people with early-stage cirrhosis, the liver still works relatively well. This is known as compensated cirrhosis. Later, when the liver can no longer carry out its vital functions,

they may progress to decompensated cirrhosis. People with advanced liver disease may experience a wide range of complications, including: 

Blockage of blood flow through the liver (portal hypertension)
Abdominal bloating due to fluid accumulation (ascites)
Swelling, especially in the legs and ankles
Easy bleeding and bruising
Blood vessels that resemble spider webs on the skin
Enlarged blood vessels (varices) in the esophagus and stomach that can cause internal bleeding
Brain damage leading to drowsiness and impaired mental function (hepatic encephalopathy).

Liver biopsies, imaging scans and blood tests are used to monitor liver disease progression. A biopsy involves inserting a hollow needle into the abdomen to take a small sample of liver tissue to examine under a microscope. A biopsy can show how much scar tissue or fat is present in the liver. Ultrasound scans are be used to show liver fat accumulation, and a technique known as transient elastography (FibroScan) measures liver stiffness, which helps estimate the degree of fibrosis.

Several methods are used to classify liver damage. The METAVIR system ranks the level of inflammatory activity and fibrosis:

Stage F0: no fibrosis
Stage F1: mild fibrosis
Stage F2: moderate fibrosis
Stage F3: advanced fibrosis
Stage F4: cirrhosis.

Child-Pugh-Turcott and MELD (Model for End-Stage Liver Disease) scores are used to classify advanced liver disease, predict how long a patient is likely to live and prioritize people for liver transplants.

Can HIV drugs cause liver damage?

Like many medications, certain antiretroviral drugs can harm the liver, known as hepatotoxicity. Fortunately, modern antiretrovirals are generally much easier on the liver than older meds that are no longer widely used.
Liver damage is most likely to occur with drugs that are mainly processed by the liver (others are mainly processed by the kidneys). Some meds can trigger a hypersensitivity or allergic reaction that can harm the liver. Older nucleoside reverse transcriptase inhibitors can damage the mitochondria, tiny structures inside cells that produce energy. This can lead to lactic acidosis, an elevated level of the cellular waste product lactase, which can lead to liver inflammation and fat buildup.

The risk of drug-related liver injury is greatest when drugs are taken at high doses or when multiple medications that affect the liver are taken together. In some cases, drugs can interact with each other in ways that lead to higher—and sometimes dangerous—levels in the body. People with preexisting liver disease (especially those with advanced cirrhosis), older individuals and people who drink heavily are more prone to drug-related liver problems.

At early stages, drug-related liver toxicity may have no symptoms. Measuring liver enzyme levels can help show whether drugs are causing liver damage. These tests are an important part of ongoing monitoring for people on antiretroviral treatment, especially after starting new meds. However, elevated liver enzymes are not specific to drug-related liver injury and are also seen in people with other liver conditions.

Drug-related liver damage usually comes on slowly, and regular monitoring can catch problems before they become serious. Such problems are often reversible when the offending drugs are stopped.

What liver diseases are common among people with HIV?

As antiretroviral treatment has extended the lives of people with HIV, liver disease has become a leading cause of illness and death in this population.

Hepatitis B and hepatitis C are transmitted in some of the same ways as HIV—including sex and sharing equipment to inject drugs—and many HIV-positive people have one or both of these viruses, known as coinfection. All people living with HIV should be screened for hepatitis B and C. Studies have shown that people with HIV and hepatitis B or C tend to experience more rapid liver disease progression and more severe complications.

Hepatitis A is not transmitted in the same ways as HIV, but outbreaks have been reported among groups with high HIV rates, including homeless people and people who inject drugs. Some studies suggest that people with HIV might take longer to fully recover from hepatitis A. The Centers for Disease Control and Prevention (CDC) recommends that all people living with HIV, as well as those who are at risk for HIV via sexual transmission or drug use, should be vaccinated against hepatitis A and B.

Studies have shown that people with HIV have a higher rate of alcohol use disorders than the general population, and this can lead to alcoholic liver disease.

Fatty liver disease (NAFLD and NASH) is common among HIV-negative people, affecting around a third of the general population. But people living with HIV appear to be at even high risk. Now that hepatitis C can be readily cured, fatty liver disease has become a leading cause of advanced liver disease in HIV-positive and HIV-negative people alike.

PS:

Tenofovir intermediate DESMP Diethyl (tosyloxy)methylphosphonate CAS:31618-90-3

DESMP is an intermediate of tenofovir and can be used in the synthesis of a variety of antiviral drugs.

Packaging:

1). 1kg/bottle (1kg net weight, 1.2kg gross weight)

2). 5kg/drum(5kg net weight, 5.2kg gross weight)

3). 1T/IBC Tank (1000kg net weight, 1183kg gross weight; packed in a export worthy IBC tank)