Deficits in cell-mediated immunity in AIDS result in a wide variety of hepatic complications, including granulomas, cytomegalovirus hepatitis, multimicrobial AIDS cholangiopathy, Kaposi's sarcoma, and lymphoma. Kupffer cells are the major hepatic target cell population for human immunodeficiency virus-1 (HIV-1), and rhesus monkeys with simian immunodeficiency virus infection have served as a model for ultrastructural analysis of viral clearance by these cells. The majority of patients with established AIDS reveal abnormalities on serum liver tests. In these individuals, the differential diagnosis includes opportunistic infections and neoplasms, as well as possible concomitant chronic viral hepatitis B, C, D, and G, and drug hepatotoxicity. This article reviews the spectrum of hepatic pathology in AIDS and discusses the effects of HIV-1 infection on hepatitis virus infections.