HIV treatment, primarily through antiretroviral therapy (ART), can cause a range of side effects. Most people will experience only mild or no side effects, especially with newer medications, but both short-term and long-term adverse effects are possible.[4]
Common short-term side effects are usually a result of the body adjusting to new medications. These side effects often decrease or disappear after a few weeks and may include:
- Diarrhea
- Nausea or vomiting
- Fatigue or feeling tired
- Headache
- Loss of appetite
- Mood changes such as anxiety or depression
- Sleep disturbances
- Rash
Less commonly, pain or soreness at the injection site can occur with injectable medications.[3][5]
Long-term or more serious side effects can emerge either after extended use or due to specific drug sensitivities. These may include:
- Liver injury or increased liver enzymes
- Kidney dysfunction
- Decrease in bone mineral density (risk of osteoporosis)
- Metabolic effects: changes in fat distribution (lipodystrophy), increased cholesterol or triglycerides, and insulin resistance or new-onset diabetes
- Cardiovascular effects such as increased risk for heart disease
Long-term toxicities are now less common with newer ART regimens, but vigilance is required, particularly for patients with pre-existing conditions.[4][6]
Severe or life-threatening reactions are rare but require immediate attention. Examples include:
- Hypersensitivity reaction (especially with abacavir): symptoms include fever, rash, malaise, muscle aches, nausea, and abdominal pain. This can be life-threatening and typically occurs within weeks of starting the drug.[1]
- Lactic acidosis (mainly with NRTIs): presents as persistent nausea, vomiting, fatigue, shortness of breath, and can be fatal.[1][2]
- Severe skin rashes with blisters, mouth or genital ulcers, peeling skin, fever, and headache.[1]
- Hepatotoxicity: severe liver injury, sometimes requiring discontinuation of therapy.[2]
Many side effects are manageable. Mild effects may subside on their own; if not, your healthcare provider can suggest ways to reduce symptoms or recommend alternate medications. Serious effects may require switching drugs, but this must be done carefully to maintain HIV suppression and avoid further adverse reactions.[3][5]
Drug interactions and other health conditions can also influence the side effects of HIV therapy. It is important to inform your healthcare provider about any other medications, supplements, or health issues you have before starting or changing HIV treatment.[3][6]
References
- [1] AIDS and HIV Medication Side Effects Chart – WebMD
- [2] Adverse effects of antiretroviral therapy for HIV infection – PMC
- [3] Antiretroviral HIV Drugs: Side Effects and Adherence – Healthline
- [4] Core Concepts – Adverse Effects of Antiretroviral Medications
- [5] Side-effects of HIV treatment – Aidsmap
- [6] Adverse Effects of Antiretroviral Agents | NIH – Clinical Info HIV.gov