HIV Treatment Side Effects
What are the risks of HIV medications?
What are the most common side effects of HIV medications?
Perhaps the most common side effect of HIV medications these days would be actually from Sustiva, because Sustiva is a very commonly used drug. It's part of Atripla, and it can cause weird dreams and dizziness, especially when people start therapy, and it often wears off. Sometimes this HIV medication can make patients irritable or depressed, in which case they should stop taking it. It's a common side effect, but is normally not serious and usually wears off. However, some patients will have to change drugs because they won't tolerate it. Both Sustiva and Viammune can cause rashes, just as almost any drug in the pharmacy can cause a rash, but the incidence of rash with Sustiva and Viamune is about 15%. In some patients, they can go on taking it and the rash will fade away, others will have to stop the drug because of a rash. With Protease inhibitors, the most common side effects are in the gastrointestinal tract, usually meaning loose stools, sometimes frank diarrhoea (although usually not), and maybe some bloating and some feeling of gas. That's very common, but, again, very minor, and less of a problem with the newer HIV medications.
What are the most serious side effects of HIV medication?
The most serious side effects with HIV medications is very rare, and that is lactic acidosis. I have only seen a couple of cases in my life, so it really is very rare. Lactic acidosis means that the body becomes very acidic. The patients get short of breath. The body is very intolerant of high acid levels, and that can lead to death quite quickly. But, thankfully, it's very rare. We do see it overseas a bit, in resource limited settings, where the drugs that we use mostly are indeed AZD 14 DDI, where other drugs are not available in most countries. Other serious side effects, thankfully, are rare. But, if kidney function or liver function is affected, that's bad. Very rarely, with viralkin, the liver can seriously be damaged, very rapidly. If the drug, however, is used only when C4 counts are very low, we've found that doesn't occur hardly at all. But, we do have to warn patients, if they feel sick when they go on those drugs they should let us know quickly. Tenofovir can cause renal damage, but it's very rare. In the clinical trials, they didn't even see it, but we do see it sometimes, but it's slowly developing and reverseable, we just have to watch for it. Sometimes skin rashes can be very severe. Again, it's very rare, but with the virakin and some of the other drugs, a very serious skin rash can occur which can sometimes be fatal. So there are some serious side effects, they don't occur very often, but they do exist.
What's the best way to deal with nausea and vomiting due to HIV medication?
The best way to deal with nausea due to HIV medication is probably to change the HIV medication. It may be OK to put up with nausea for a week or two to see if it wears off, but I always tell my patients nausea is an awful side effect of HIV medication, and you shouldn't have to tolerate that. It's caused by a few HIV medications, and you can switch away. Occasionally you see it with AZT; not very often with any of the other HIV medications.
What are 'body shape changes' that occur with HIV medication?
How can I combat body shape changes due to HIV medication?
If you already have lipoatrophy or fat deposition, body shape changes from nucleosides, it's probably a good idea to get off the drugs that probably caused the body shape change if you can, if you are not resistant to lots of drugs. And if you are still on them you may have already been switched off them. Apart from that, which will stop the body shape change problem from getting worse and may reverse it slightly, there are cosmetic procedures that can be done to improve appearance. There's not much you can do about the arms and legs looking skinny as a result of HIV medication, but they are various compounds that can be injected into the cheeks to fill them up and make them look normal again.
