The emergence of liver diseases as one of the major causes of death in people infected with HIV has paralleled the introduction of more effective anti retroviral therapies. HIV/AIDS induced lipid profile alteration has been proven to be a common problem in HIV/AIDS. Studies were carried out to determine the effects of anti retroviral treatment on liver enzymes of patients and evaluate the changes in lipid profile and body mass index (BMI) in HIV/AIDS patients on anti retroviral and anti-tuberculosis therapies. Results showed that highly active anti retroviral therapy is associated with low hepatotoxicity at therapy initiation, regardless of drug class or combination. There is a positive linear relationship between duration of treatment and concentration of transaminases over the years. There is a significant positive correlation between CD4+ counts and BMI in HIV positive patients on treatment. Tuberculosis worsens the immune suppression caused by HIV and enhances HIV-induced lipid profile changes. Anti retroviral drugs when coupled to anti tuberculosis induces complex lipid profile and BMI alterations. These results suggest a need for routine laboratory and dietary monitoring.