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They may lead to hepatotoxicity by different mechanisms, namely, mitochondrial damage by nucleoside analogs like didanosine and stavudine, hypersensitivity reactions by nevirapine, efavirenz, or abacavir, direct liver injury byusing full doses of ritonavir and immune reconstitution phenomena, mainly in severely immunosuppressed patients with underlying chronic hepatitis B virus [HBV]

acutely injured kidneys may be enlarged on ultrasound whereas chronically diseased kidneys are usually smaller than normal