ARV side effects
The main treatment for HIV is a class of drugs called antiretrovirals. These drugs don’t cure HIV, but they can dramatically reduce the amount of virus in the body so it can’t destroy the immune system.
Today, more than 20 antiretroviral drugs are approved to treat HIV. Most people will take two or more of these drugs every day for the rest of their lives. You have to take antiretroviral drugs at the right time and in the right way in order for them to work. Taking your medicines the way your doctor prescribed them is called “adherence.”
The anti retroviral treatment regimen isn’t easy. These drugs can cause side effects, which can be severe enough to make some people stop taking them. If you skip doses, the virus can start copying itself in your body again. It could become resistant to the medicine you are taking, leaving you with fewer effective options to treat your HIV. That’s why it’s so important to work closely with your doctor to find the best drug for you, and to address side effects right away if you experience them.
Side Effects
Antiretroviral Drug Side Effects — And How to Treat Them
Most medicines you take can cause side effects. HIV drugs are no exception. Some of the side effects they cause are mild. Others are more severe, or even life threatening. A side effect can get worse the longer you keep taking the drug.
It’s also possible for other medications you take to interact with your HIV medications. Additionally, other conditions you have may amplify the side effects from these drugs (for example, viral hepatitis can worsen effects on the liver from HIV drugs). That’s why, when you start taking any new drug, you should tell your doctor and pharmacist about all the other medicines you take — even drugs you buy over the counter without a prescription.
Here are some of the most common side effects from antiretroviral treatment, and ways your doctor might recommend to manage them:
Appetite Loss
Antiretroviral drugs that cause it: Abacavir (Ziagen)
What you might do to help:
Eat several small meals a day, instead of three big ones.
Drink nutritional supplements or smoothies to make sure you get enough vitamins and minerals.
Take an appetite stimulant.
Changes in the Distribution of Body Fat (Lipodystrophy)
Antiretroviral drugs that cause it: combinations of drugs from the NRTI and protease inhibitor classes (although some people with HIV who aren’t on these drugs also have this side effect)
What you might do to help:
Exercise to lose weight in areas where you’ve gained fat, such as in the stomach.
Get injections of polylactic acid (New Fill, Sculptra) in your face if you’ve lost weight there.
Have liposuction to remove fat in other areas where it has collected.
Ask your doctor about trying a drug called tesamorelin (Egrifta), which reduces excess belly fat in people who take HIV medicine.
Diarrhea
Antiretroviral drugs that cause it: Protease inhibitors and other medicines
What you might do to help:
Eat fewer greasy, fatty, spicy, and dairy foods.
Eat less insoluble fiber (raw vegetables, whole grain cereal, nuts).
Take over-the-counter anti-diarrheal medicines such as loperamide (Imodium) or diphenoxylate and atropine (Lomotil).
Fatigue
Antiretroviral drugs that cause it: Many different drugs
What you might do to help:
Eat healthy foods to give you more energy.
Exercise as often as you can.
Avoid drinking alcohol and smoking.
Higher than Normal Levels of Cholesterol and Triglycerides (Lipids) in the Blood
Antiretroviral drugs that cause it: Protease inhibitors and other medicines
What you might do to help:
Stop smoking.
Exercise more.
Reduce the amount of fat in your diet (talk with a dietitian about the safest way to do this).
Eat fish and other foods that are high in omega-3 fatty acids.
Have blood tests at your doctor’s office to check your cholesterol and triglyceride levels.
Take statins or other lipid-lowering medicines if you need them.
Mood Changes, Depression, Anxiety
Antiretroviral drugs that cause it: Efavirenz (Sustiva)
What you might do to help:
Change the timing of your medicine dose (talk to your doctor first).
Avoid alcohol and recreational drugs.
Try talk therapy or antidepressant medicines.
Nausea and Vomiting
Antiretroviral drugs that cause it: Almost all of them
What you might do to help:
Eat smaller portions several times during the day, instead of three big meals.
Eat bland foods like plain rice and crackers.
Avoid fatty, spicy foods.
Serve your meals cold, instead of hot.
Take anti-emetic medicines to control nausea.
Rash
Antiretroviral drugs that cause it: Nevirapine and other drugs
What you might do to help:
Moisturize your skin by applying lotion daily and avoiding hot showers and baths.
Use mild, non-irritating soaps and laundry detergents.
Wear fabrics that breathe, like cotton.
Ask your doctor if you can take an antihistamine medicine.
Trouble sleeping
Antiretroviral drugs that cause it: Efavirenz (Sustiva) and other medicines
What you might do to help:
Exercise regularly.
Stick to a sleep schedule and avoid naps.
Make sure your bedroom is comfortable for sleep.
Relax before bedtime with a warm bath or other calming activity.
Avoid caffeine and other stimulants within a few hours of bedtime.
Talk to your doctor about sleep medicines if the problem continues.
Other side effects from antiretroviral drugs include: