Common Side Effects Of Hiv Drugs
The following chart lists some HIV medication side effects that are more common and a few special precautions. To prevent interactions with other medicines, it is important to tell your doctor about all drugs you take. Also tell your doctor right away if you have new, unusual, or long-lasting symptoms.
|Nucleoside Reverse Transcriptase Inhibitors||Common Side Effects|
- Stopping protease inhibitors, but only under the guidance of your doctor
- Hypoglycemic drugs taken by mouth
- Insulin injected under the skin
Hyperlipidemia is an increase of fat in the blood. These fats include cholesterol and triglycerides. This condition can lead to heart disease and pancreatitis, an inflammation of the pancreas. Some protease inhibitors can increase this side effect.
Symptoms of hyperlipidemia do not exist. The only way to know if you have this condition is to have lab tests at least once a year.
Treatment of hyperlipidemia includes taking cholesterol-lowering drugs, such as statins or fibrates.
Lipodystrophy is also called fat redistribution. If you have it, your body produces, uses, and stores fat differently. This side effect is associated with the use of both NRTIs and PIs as well as the HIV virus itself. It is less common with the newer medications.
Symptoms of lipodystrophy include:
- A buildup of fat in the neck or upper shoulders, belly, or breasts
- A loss of fat in the face, arms, legs, or buttocks
Treatment of lipodystrophy may include:
Symptoms of liver damage include:
Renal And Metabolic Disorders
Older PLWH are at an increased risk of developing premature renal failure and DM compared with the general population . A cross-sectional retrospective casecontrol study found that PLWH had a higher prevalence of both renal failure and DM compared with HIV-uninfected controls, especially among those aged> 60 years . Among PLWH in the John Hopkins HIV Clinical Cohort who developed CKD , the adjusted IRRs were 3.47 and 1.45 for those > 55 years and 4555 years old, respectively, relative to PLWH< 45 years of age .
Toxicity resulting from long-term ART use that affects renal and metabolic health may further compound the overall disease burden in aging PLWH. Long-term use of ART has been linked to an increased risk of CKD and DM. In particular, an analysis of over 10,000 patients demonstrated a 33% increased risk of CKD for each additional year of tenofovir disoproxil fumarate use . A similar analysis of 21,590 HIV-infected men found that the overall 5-year event rate of CKD in tenofovir disoproxil fumarate users compared with non-users was 7.7% versus 3.8%, respectively . Based on findings from the EuroSIDA study, higher rates of CKD have also been associated with a more frequent use of atazanavir and lopinavir/ritonavir . Finally, in a prospective study of 1524 HIV-infected women with no evidence of DM, longer cumulative use of NRTIs was associated with an increased incidence of DM over the study period compared with no use of NRTIs .
Which Hiv Medications Should I Take
When it comes to thinking about which HIV medications you should take, it can be a bit confusing and overwhelmingespecially if you’re newly diagnosed and have never had to take ART before. As mentioned earlier, there are many classes of medications that slow down HIV at different points of its life cycle. These meds are usually combined in easy-to-take, once-a-day pills. Only question is: Which one is best for you?
First off, educate yourself about the various recommended ART regimens and be prepared to have an active discussion with your health care provider about what option may be best for you.
There are many things you should consider when making this decision:
- Have you had an HIV drug resistance test, and do you know what medications will work best?
- What are the potential side effects of the different ART regimens?
- Are you starting meds for the first time, or are you considering changing your meds?
- What other medical conditions do you have?
- What other medications are you taking? Will there be any interactions?
- What is your daily life and work schedule like, and how might that affect the timing of your doses?
- What home and life conditions will help you take the medications daily as you should?
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Growing Older With Hiv
Today, thanks to improvements in the effectiveness of treatment with HIV medicine , people with HIV who are diagnosed early and who get and stay on ART can keep the virus suppressed and live long and healthy lives. For this reason, nearly half of people living with diagnosed HIV in the United States are aged 50 and older. Many of them have been living with HIV for many years others were diagnosed with HIV later in life.
Thats a significant change from the early years of the epidemic when people who were diagnosed with HIV or AIDS could expect to live only 1-2 years after their diagnosis. This meant that the issues of aging were not a major focus for people with HIV disease.
According to the Centers for Disease Control and Prevention , in 2018, over half of people in the United States and dependent areas with diagnosed HIV were aged 50 and older. In addition, people aged 50 and older accounted for 17% of the 37,968 new HIV diagnoses in 2018 in the United States and dependent areas. Though new HIV diagnoses are declining among people aged 50 and older, around 1 in 6 HIV diagnoses in 2018 were in this group.
People over age 50 with HIV make up 46.8% of the over half a million clients served by the Ryan White HIV/AIDS Program . In 2019, 92.2% of clients aged 50 and older receiving RWHAP HIV medical care were virally suppressed, which was higher than the national RWHAP average .
The 10 Most Common Side Effects Of Hiv Medication
Turns out, most aren’t as common as you think.
There are actually side effects to almost all new medications, so its not uncommon to feel aches and pains, headaches, stomachaches, or fatigue for a few days . Anything beyond that and you should tell your doctor. One 2008 study showed that 60 percent of people on antiretrovirals had diarrhea, but that was before the Food and Drug Administration approved Fulyzaq, the first antidiarrheal drug for people with HIV.
Side effects to HIV meds used to be brutal if you lived through the last few decades, you probably remember but with newer medications on the market, the majority of people will not experience any serious side effects. If you do, your doctor should help you find a treatment that works for you without them.
AIDS.gov has a list of the most common long-term effects of HIV meds on some users, which include lipodystrophy insulin resistance increases in cholesterol or triglycerides decreases in bone density , and lactic acidosis .
Bottom line: They are rarely severe, but if you have any side effect longer than a few weeks, dont just assume you have to just put up with it ask your doctor about it.
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What Are Antiretrovirals And Why Do I Need Them
HIV damages your immune system by attacking blood cells that help fight infection. Acquired Immune Deficiency Syndrome is the condition that develops if HIV is not treated.
The medicines used to fight HIV are called antiretrovirals. They work to stop the virus multiplying. This helps protect your immune system from damage caused by HIV.
The medications used to treat HIV and AIDS may be similar.
If there is damage to your immune system, medicines can help stop further damage and even allow your immune system to partly repair itself.
Theres no cure for HIV and AIDS, but if youre careful to take your HIV medicines regularly, youre likely to live a long, healthy life, like most HIV-positive people in Australia.
Will Side Effects Go Away
Most peoples side effects go away within a few weeks of starting treatment.
If yours are not going away, the best thing you can do is talk to a medical professional about it. They can tell you what to do and may prescribe something for you to take for a short period, such as an anti-nausea drug. Tell them about any other medications you are taking in case there is an interaction between the drugs you take.
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What About Hiv Medication Side Effects
Many years ago, HIV medications used to have a lot of side effects, and they were often severe. But the meds people commonly use today are much, much safer.
There are always potential side effects with every medication we take, including over-the-counter pain medications, drugs that control fevers, and treatments for high blood pressure. HIV drugs are no different.
The key word to remember is potential side effects. Complications from HIV medications are not guaranteed to happen, and if they do, they are not the same for everyone. Before you say no to taking a medication because someone you know had a bad reaction or you remember an old report about toxic HIV drugs, do more research: talk to your medical team, as well as other people living with HIV. A medication that didnt work for one person may be your saving grace.
Antiretroviral Drug Side Effects And Management
HIV drugs have improved over the years, and serious side effects are less likely than they used to be. However, HIV drugs can still cause side effects. Some are mild, while others are more severe or even life threatening. A side effect can also get worse the longer a drug is taken.
Its possible for other medications to interact with HIV drugs, causing side effects. Other health conditions can also make the side effects from HIV drugs worse. For these reasons, when starting any new drug, people with HIV should talk with a healthcare professional and pharmacist about all the other medications, supplements, or herbs theyre taking.
In addition, if any new or unusual side effects occur, people with HIV should contact a healthcare professional. They should do this even if theyve been on the medication for a long time. It can take months or years to start reacting to a drug.
For serious side effects, a healthcare professional might make sure that its the medication and not another factor thats causing the symptoms. If the drug is to blame, they might switch treatment to another antiretroviral drug. However, switching treatments isnt easy. They need to be sure that the new treatment will still work and that it wont cause even more severe side effects.
Here are some of the more common side effects from antiretroviral drugs and tips for managing them.
Loss of appetite happens when you have a decreased desire to eat.
Examples of drugs that may cause it:
What might help:
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How To Deal With Side Effects From Hiv Treatment:
When you first start treatment for HIV, you may have experienced headaches, an upset stomach, fatigue, or aches and pains. These side effects usually go away after a brief adjustment period, lasting anywhere from a few days to a month. If you notice any unusual or severe reactions after starting or changing a drug, report the side effects to your healthcare provider immediately.
Dealing with medication side effects can be a huge barrier to starting and continuing HIV medications. Dont let these derail your treatment plan or discourage you from starting in the first place. It is never a good idea to stop treatment without first consulting your healthcare provider, as this may cause HIV to develop drug resistance.
What Types Of Antiretrovirals Might I Be Prescribed
Types of antiretrovirals include:
- integrase inhibitors
- entry inhibitors
If you have HIV, youll usually be prescribed a few different antiretrovirals at the same time at least 3 medicines from at least 2 of the 5 classes. This is known as combination therapy. Some HIV medications are single pills that combine more than one medicine. Sometimes you might be given 1 or 2 different pills, but these can actually be 3 different medicines.
As well as antiretrovirals, your treatment can include medicines to guard against infections, as your immune system may no longer be able to fight them.
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Economic Burden Associated With Art
There is limited evidence describing the economic burden associated with cumulative toxicity that results from long-term ART use in older PLWH. Nevertheless, short-term toxicity-related costs among PLWH who are treated with ART have been documented, and there is an expectation that healthcare costs will increase commensurately as PLWH age. In a retrospective Medicaid claims analysis of PLWH treated with ATV or darunavir , the mean±SD per-patient per-month costs of all medically attended AEs were US$3879±$6635 and $5354±$8127, respectively . In another US claims analysis of PLWH treated with NNRTIs , mean total healthcare costs were estimated to be $27,299±$37,170, and annual AE-associated costs were $608±$3897 . Costs varied from $586 for lipid disorders to $4434 for nausea/vomiting. A retrospective US casecontrol study found that for patients who had initiated ART within the last 12 months, the median difference in total all-cause healthcare costs was $3310 for managing diabetes/insulin resistance, $2792 for lipid disorders, $1389 for a renal disorder event, $390 for rash, $357 for a somnolence/sleep event, and $212 for a hepatic disorder event . Aging in the population of PLWH is likely to add to the cost of HIV management between 1999 and 2011, the proportion of older PLWH increased from 9.6 to 25.4%, and proportional costs increased from 25 to 31% .
Does Prep Have Risks
People with HIV have used Truvada, tenofovir and emtricitabine, for several years. They are generally easy to take. Possible long-term side effects include loss of bone mineral density and kidney damage.
Some people worry that people taking PrEP might think they are totally protected. They might be less careful about their sexual behavior. So far, this does not appear to be true.
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How Is Prep Taken
PrEP is currently one tablet of Truvada daily. It can be taken with food, or between meals.There is research ongoing to look at other medications for PrEP.
PrEP is more than simply taking HIV pills. The US Centers for Disease Control and Prevention has issued guidelines for the use of PrEP. One set of guidelines is for men who have sex with men. Another is for heterosexuals.
Basic Info About Prep Medication Side Effects
Like any other medicine, PrEP drugs could have an adverse reaction on its users. People have different body systems and thus, somebody systems may react temporarily to the drug. The reactions may be very mild or severe .
Potential side effects that may result from the use of PrEP meds are usually short-lived and are noticed during the first two weeks of commencing the procedure. These side effects are not permanent and often fade away once the users body system adjusts to the pill. Clinical trials reveal that the major side effect observed by users was nausea. Only a tiny fraction of users who experienced side effects found them severe/ crucial enough to stop taking the drug.
Side effects that may result from PrEP could either be short-term or long-term. However, cases of long-term side effects do not occur frequently.
It is important to note that only a small percentage of users of the PrEP pills often experience short-term side effects and an even smaller percentage experience the long-term effects. Similarly, the side effects of PrEP medications do not usually have any physical manifestation.
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I Cant Cope With These Side Effects What Can I Do
You must keep taking your treatment until youâve spoken to a medical professional. This is because, if you stop, it risks HIV becoming resistant to the drugs which could mean the drugs donât work for you anymore.
If a side effect doesnât go away and is affecting your quality of life, your healthcare provider may recommend that youâ¯switch drugs.
Clinical Guidelines For Hiv Treatment: Strategies That Optimize Success
Andrew R. Zolopa, MD
The International AIDS Society -USA Panel hasrecently updated their recommendations.4 According to theseguidelines, ART should be initiated in asymptomatic patients withCD4+ cell counts < 500 cells/mm3. Furthermore, ART should beconsidered in patients with CD4+ cells counts > 500cells/mm3, unless the patient is an elite controller or has stable CD4+ cell counts and low-level viremiain the absence of ART. There are also specific conditions for which ART isrecommended regardless of CD4+ cell count. Like the DHHS guidelines,IAS-USA guidelines recommend that ART is initiated in pregnant women, patientswith hepatitis B co-infection, and patients with HIVAN. However, IAS-USArecommends the initiation of therapy in patients with other conditions, such ashepatitis C co-infection, levels of HIV-1 RNA > 100,000 copies/mL, rapiddecline in CD4+ cell count ,and high risk for secondary HIV transmission .Furthermore, the IAS-USA recommendations indicate that ART should be initiatedin patients with cardiovascular disease or who are at significant riskfor CVD, which may seem counterintuitive given the association of ART with CVDrisk. However, HIV is coming to be recognized as an important contributor toCVD-associated morbidity and mortality, which will be discussed later in thismonograph.
Rationale for Initiating Therapy Earlier
There are several studies which support the rationalefor initiating ART as early as possible.
IAS-USA 2010: Guidelines for Initial ART Regimens
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Side Effects Not Requiring Immediate Medical Attention
Some side effects of abacavir / dolutegravir / lamivudine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- loss or thinning of the hair
- weight gain around your neck, upper back, breast, or waist