Highly Active Antiretroviral Therapy for Patients With Primary Biliary Cirrhosis

Inclusion Criteria: 1. Patients 18 years old of either sex will be recruited for this study. 2. Elevated ALP after 6 months UDCA therapy ≥ 2 x upper limit of normal or abnormal bilirubin. 3. Positive serum AMA or Liver biopsy histology compatible with PBC. 4. Maintained on UDCA at a dose of 13-15 mg/kg for 6 or more months. 5. Patients must read and sign informed consent form Exclusion Criteria: 1. Subjects with baseline AST or ALT \> 5 x ULN. 2. Patients who have altered dose of any medications used to treat PBC (such as UDCA) or the use of colchicine, corticosteroids, azathioprine, chlorambucil, methotrexate, or D-penicillamine within the last 6 months. 3. Advanced liver disease or esophageal varices, INR \> 1.2 (upper limit of normal), Albumin \< 35 g/L (lower limit of normal), platelets \< 120,000/mm3, Childs Pugh class B or C cirrhosis, presence of varices or previous variceal hemorrhage, spontaneous encephalopathy, ascites or need for liver transplantation. 4. Patients with a secondary diagnosis such as HIV, viral hepatitis, drug induced liver injury, extrahepatic biliary obstruction, primary sclerosing cholangitis, metabolic liver diseases or alcoholic liver disease Regular use of more than 30 g of alcohol per day in the last year. Clinically apparent pancreatitis or with a predicted survival of less than 3 years from malignant or other potentially life threatening disease. 5. An ultrasound showing a hepatic mass consistent with hepatocellular carcinoma within the last year in patients with cirrhosis. 6. Previous allergic reaction to study medications. 7. Creatinine clearance less than \< 70 mL/min using the Cockcroft Gault equation: Creatinine clearance (mL/min) = (140 - age) x body wt (Kg) x 0.85 (if female)/serum creatinine in mol/l 8. Pregnancy or breast-feeding a child. Young sexually active patients not using contraception 9. Young sexually active patients not using contraception.