Hiv meds side effects

These steps can help you manage some of the most common side effects:

Fatigue. Try brief, 20- to 30-minute naps. Cut back your work schedule if you can. Balanced meals will give your body fuel, and gentle exercise can boost your energy.

Feeling queasy and throwing up. You need to take some HIV medicines with food. Make sure you know which ones they are. Avoid eating things that could trigger an upset stomach. Ginger — in ginger ale, ginger tea, or gingersnaps — may help settle your tummy. Eat some crackers in the morning. Stick with small meals and cold foods. Drink a lot of water to stay hydrated. Don’t take antacids or other over-the-counter products unless your doctor says it’s OK.

Diarrhea. Drink plenty of fluids so you don’t get dehydrated. Talk to your doctor about which over-the-counter (OTC) diarrhea products are safe to take.

Headaches. An OTC pain reliever may work. Rest, drink plenty of fluids, and stay away from loud noise and bright light.

Insomnia. Limit caffeine and avoid heavy meals close to bedtime. It may be tempting, but try not to take daytime naps; stay on a regular sleeping schedule. Try relaxing bedtime habits such as warm baths, warm milk, soothing music, or massage to tell your body it’s time to sleep.

Rashes. Avoid long, hot showers or baths, and skin products with alcohol or harsh chemicals. Use sunscreen and moisturizing lotions or petroleum jelly on dry, itchy areas.

Skin reactions to injections. If you have to give yourself shots, check with your doctor to make sure your technique is good. Change the site to give your skin and tissues a chance to heal. Warm the medicine in your hands before you inject it, and apply a cold pack to the area afterward.

Pain, tingling, or numbness in your feet or hands. Gently massage them. Wear loose-fitting shoes or jewelry. Over-the-counter pain relievers like ibuprofen or naproxen may help.

Dry mouth. Suck on sugarless candies or lozenges, or chew sugarless gum. Drink plenty of liquids. Avoid sugary or sticky foods and caffeine.

Remember that all of these can also be signs of a health problem that isn’t related to your HIV treatment. Always call your doctor if you’re thinking about stopping a medication because of side effects. If you have serious symptoms, whether they’re linked to your medicines or not, call the doctor. If they’re very serious, call 911.

In This Section

  • HIV & AIDS
  • What are the symptoms of HIV & AIDS?
  • Should I get tested for HIV?
  • How do I get treated for HIV?
  • How do I prevent HIV?
  • Living with HIV
  • What is PrEP?
  • What is PEP?

People with HIV don’t usually have symptoms right away, so they may not know they have it. It can be years before HIV makes you feel sick.

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Early HIV symptoms

People usually look and feel totally healthy for a long time after they’re infected. It can take 10 years or more for HIV to show any symptoms — or much, much longer than that for people who take HIV medicines. That’s why it’s really important to get tested for HIV regularly, especially if you’ve had unprotected sex or shared needles. HIV treatment can help you stay healthy. Treatment can also lower or even stop your chances of spreading HIV to other people during sex.

The first 2-4 weeks after being infected with HIV, you may feel feverish, achy, and sick. These flu-like symptoms are your body’s first reaction to the HIV infection. During this time, there’s a lot of the virus in your system, so it’s really easy to spread HIV to other people. The symptoms only last for a few weeks, and then you usually don’t have symptoms again for years. But HIV can be spread to other people — whether or not you have symptoms or feel sick.

Later HIV/AIDS symptoms

HIV destroys cells in your immune system called CD4 cells or T cells. Without CD4 cells, your body has a hard time fighting off diseases. This makes you more likely to get really sick from infections that usually wouldn’t hurt you. Over time, the damage HIV does to your immune system leads to AIDS.

You have AIDS when you get rare infections (called opportunistic infections) or types of cancer, or if you’ve lost a certain number of CD4 cells. This usually happens about 10 years after getting HIV if you don’t get treatment. Treatment can delay or even prevent you from ever developing AIDS.

The signs of AIDS include:

  • Thrush (a thick, white coating on your tongue or mouth)

  • Sore throat

  • Bad yeast infections

  • Chronic pelvic inflammatory disease

  • Getting bad infections a lot

  • Feeling really tired, dizzy, and lightheaded

  • Headaches

  • Losing lots of weight quickly

  • Bruising more easily than normal

  • Having diarrhea, fevers, or night sweats for a long time

  • Swollen or firm glands in your throat, armpit, or groin

  • Deep, dry coughing spells

  • Feeling short of breath

  • Purplish growths on your skin or inside your mouth

  • Bleeding from the mouth, nose, anus, or vagina

  • Skin rashes

  • Feeling very numb in your hands or feet, losing control of your muscles and reflexes, not being able to move, and losing strength in your muscles

More questions from patients:

What are some symptoms of AIDS in women?

Like many STDs, AIDS symptoms in women are quite similar to the symptoms of AIDS in all genders.

AIDS is the most advanced stage of HIV (human immunodeficiency virus). People with HIV may have symptoms in the very beginning of their infection, like swollen glands, fever, headaches, and muscle soreness.

You may not have any symptoms at all for up to 10 years. At that point, HIV begins to make it hard for your body to fight off infections, so you can get infections that normally wouldn’t affect you.

When your immune system reaches a certain point of weakness, that’s when HIV becomes AIDs.

The symptoms of AIDS in women include:

  • thrush — a thick, whitish coating of your tongue or mouth that’s caused by a yeast infection and sometimes accompanied by a sore throat

  • severe or frequent vaginal yeast infections

  • chronic pelvic inflammatory disease

  • severe and frequent infections

  • extreme and unexplained tiredness that may be combined with headaches, lightheadedness, and/or dizziness

  • quick loss of more than 10 pounds of weight that’s not from increased exercise or dieting

  • bruising more easily than normal

  • long periods of frequent diarrhea

  • frequent fevers and/or night sweats

  • swelling or hardening of glands located in your throat, armpit, or groin

  • persistent, deep, dry coughing

  • shortness of breath

  • discolored or purplish growths on the skin or inside the mouth

  • unexplained bleeding from growths on your skin, from your mouth, nose, anus, or vagina, or from any opening in the body

  • frequent or unusual skin rashes

  • severe numbness or pain in your hands or feet, the loss of muscle control and reflex, paralysis, or loss of muscular strength

  • confusion, personality change, or decreased mental abilities

If you’ve had unprotected vaginal, anal, or oral sex, STD testing — including HIV testing — is essential. Early and consistent treatment of HIV can boost your immune system and help you stay healthy.

What are some symptoms of AIDS in men?

Like many STDs, AIDS symptoms in men are quite similar to the symptoms of AIDS in all genders.

AIDS is the most advanced stage of HIV (human immunodeficiency virus). People with HIV may have symptoms in the very beginning of their infection, like swollen glands, fever, headaches, or muscle soreness.

You may not have any symptoms at all for up to 10 years. At that point, HIV begins to make it hard for your body to fight off infections, so you can get infections that normally wouldn’t affect you.

When your immune system reaches a certain point of weakness, that’s when HIV becomes AIDS.

The symptoms of AIDS in men include:

  • thrush — a thick, whitish coating of the tongue or mouth that’s caused by a yeast infection and sometimes accompanied by a sore throat

  • severe and frequent infections

  • extreme and unexplained tiredness that may be combined with headaches, lightheadedness, and/or dizziness

  • quick loss of more than 10 pounds of weight that’s not from increased exercise or dieting

  • bruising more easily than normal

  • long periods of frequent diarrhea

  • frequent fevers and/or night sweats

  • swelling or hardening of glands located in your throat, armpit, or groin

  • persistent, deep, dry coughing

  • shortness of breath

  • discolored or purplish growths on your skin or inside your mouth

  • unexplained bleeding from growths on your skin, from your mouth, nose, anus, or from any opening in your body

  • frequent or unusual skin rashes

  • severe numbness or pain in your hands or feet, loss of muscle control and reflex, paralysis, or loss of muscular strength

  • confusion, personality change, or decreased mental abilities

If you’ve had unprotected vaginal, anal, or oral sex, STD testing — including HIV testing — is essential. Early and consistent treatment of HIV can boost your immune system and help you stay healthy.

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AIDS
Signs and Symptoms

Opportunistic Infections

Below is a list of infections and how they affect different parts of the body.

Brain

Cryptoccoccal Menigitis – This is a yeast-like fungus infection that usually involves the brain and lungs, although it can affect almost any organ. The fungus that causes this condition is found in soil throughout the world. It is most common in soil contaminated by bird droppings. This disease most often occurs when a person’s CD4+ T cell count falls below 100 cells per cubic millimeter of blood.

HIV-related Encephalopathy – Encephalopathy is a term for diseases that alter brain function or structure, leading to problems with cognitive function, or mental processes, and memory. In people with HIV and AIDS, encephalopathy is usually caused by an infectious agent, such as a bacteria, virus or prion.

Encephalopathy most often occurs when a person’s CD4+T cell count falls below 50 cells per cubic millimeter of blood. Toxoplasma-seropositive patients who have a CD4+T cell count of less than 100 cells per cubic millimeter of blood should be treated with prophylaxis to prevent developing encephalopathy.

Progressive Multifocal Leukoencephalopathy (PML) – Progressive multifocal leukoencephalopathy is a rare disorder of the nervous system caused by a common human polyomavirus, JC virus. It leads to the destruction of the myelin sheath that covers nerve cells. The myelin sheath is the fatty covering that acts as an insulator on nerve fibers in the brain. Symptoms include mental deterioration, vision loss, speech disturbances, inability to coordinate movements, paralysis and ultimately coma. In rare cases, seizures may occur.

This disease can occur when the CD4+T cell count falls below 200 cells per cubic millimeter of blood.

Toxoplasmosis – This condition occurs when a parasite infects the brain. Symptoms include confusion or delusional behavior, severe headaches, fever, seizures and coma. It can affect the eye, causing eye pain and reduced vision.

Toxoplasmosis most likely occurs when the CD4+ T cell count falls below 100 cells per cubic millimeter of blood. Preventative treatment – usually with trimethoprim-sulfamethoxazole, also called Septra and Bactrim – may be administered when the CD4+ T cell count falls below 100 cells per cubic millimeter of blood.

Eyes

Cytomegalovirus (CMV) – Although this virus can affect the entire body, it commonly affects the eye’s retina, causing blurry vision and in severe cases, blindness. Other common symptoms include chronic diarrhea and nerve problems. It is most likely to occur when a person’s CD4+ T cell count falls below 100 cells per cubic millimeter of blood.

Gastrointestinal Tract

Cryptosporidiosis – This is a parasite that can cause chronic diarrhea. Other symptoms include stomach cramps, nausea, fatigue, weight loss, appetite loss, vomiting and dehydration.

This infection is difficult to treat and there is no definitive effective treatment. Symptom control and treatment of HIV are necessary.

Cytomegalovirus – Although this virus can affect the entire body, it commonly occurs in the stomach, causing fever, diarrhea and stomach pain. It most likely occurs when the CD4+ T cell count falls below 50 cells per cubic millimeter of blood.

Mycobacterium Avium Complex – This is a bacterial infection that can cause persistent fever, night sweats, fatigue, weight loss, anemia, abdominal pain, dizziness, diarrhea and weakness. The bacteria that cause this infection is found in water, dust, soil and bird droppings.

This disease most likely occurs when the CD4+T cell count falls below 50 cells per cubic millimeter of blood. Preventive treatment, usually with azithromycin, is administered when CD4+ T cells are less than 50 cells per cubic millimeter of blood.

Genitals

Candidiasis – Candidiasis is an infection caused by the candida fungi. Also known as a yeast infection, it’s the most common HIV-related fungus infection. It can affect the entire body, but most commonly occurs in the mouth, called thrush, or vagina. An overgrowth of yeast in the vagina can cause irritation, itching, burning and thick white discharge.

Herpes Simplex – This virus causes genital herpes, which are painful blisters in the genital area, or cold sores. Severe conditions are more common in the advanced stage of AIDS.

Human Papilloma Virus (HPV) – This condition is considered the most common sexually transmitted disease (STD) in the United States. It can cause warts on the anus, cervix, esophagus, penis, urethra, vagina and vulva. Studies have shown that certain types of HPV can contribute to the development of cervical and anal cancer. Individuals with HIV and AIDS are at increased risk for developing precancerous and cancerous lesions.

Liver

Liver Disease – Liver disease is one of the leading causes of death among AIDS patients, especially liver disease caused by the hepatitis B and hepatitis C virus. Many drugs used in the treatment of HIV and AIDS can cause liver disease or hepatitis. It is important that patients infected with hepatitis receive treatment and follow-up care.

Lungs

Coccidiomycosis – This infection is caused by inhaling an infective fungus called Coccidioides immitis, found mainly in contaminated soil in the southwestern United States, Mexico, Central America and parts of South America. The lungs are most commonly affected by this infection. In severe cases, it can involve the kidneys, lymph system, brain and spleen. Symptoms include cough, weight loss and fatigue. Meningitis is a common complication when left untreated.

Histoplasmosis – This infection almost always involves the lungs, although other organs may be affected. The fungus that causes this condition is found in southern parts of the United States and South America. It is usually found in soil contaminated with bird droppings and must be inhaled to cause infection.

Signs and symptoms include high fever; weight loss; respiratory complaints; an enlarged liver, spleen, or lymph nodes; depressed production of white cells, red blood cells and platelets from the bone marrow; and life-threatening, unstable, low blood pressure.

Pneumocystis Carinii – This condition occurs when a fungus infects the lungs. Symptoms may include fever, cough, difficulty breathing, weight loss, night sweats and fatigue.

It is most likely to occur when the CD4+ T cell count falls below 200 cells per cubic millimeter of blood. Preventative treatment may be administered when the CD4+ T cell count falls below 200 cells per cubic millimeter of blood. Treatment is usually trimethoprim-sulfamethoxazole, also called Septra or Bactrim, dapsone or atovoquone.

Recurrent Pneumonia – People with AIDS are at risk for recurrent bacterial pneumonia. Bacteria can infect the lungs, which may lead to problems ranging from a mild cough to severe pneumonia. Recurrent pneumonia is most likely to occur when the CD4+ T cell count falls below 200 cells per cubic millimeter of blood.

Tuberculosis (TB) – This is a serious, and often deadly, bacterial infection that primarily infects the lungs. TB is transmitted when a person with active TB coughs or sneezes, releasing microscopic particles into the air. If inhaled, these particles may transmit the condition.

Once infected by TB, most people remain healthy and develop only latent infection. People with latent infection are neither sick nor infectious. However, they do have the potential to become sick and infectious with active TB. It can occur at any CD4+ T cell level but especially when the CD4+ T cell count falls below 350 cells per cubic millimeter of blood.

Lymphatic System

Non-Hodgkin’s Lymphoma – Non-Hodgkin’s lymphoma is a disease in which tumors develop from white blood cells in the lymphatic system. It is another common disease associated with AIDS. See AIDS-related lymphoma.

Mouth and Throat

Candidiasis – This is the most common HIV-related fungus infection. It can affect the entire body, but most commonly occurs in the mouth (thrush) or vagina. An overgrowth of yeast causes white patches on gums, tongue or lining of the mouth, pain, difficulty in swallowing and loss of appetite. Candida in the esophagus, trachea, bronchi or lungs is AIDS defining.

Skin

Herpes Simplex – This virus causes cold sores or genital herpes, which are painful blisters in the genital area. Chronic herpes simplex virus (HSV) lesions and severe mucocutaneous HSV disease are common in the advanced stages of AIDS.

Kaposi’s Sarcoma – This is the most common AIDS-related cancer. It causes reddish-purple lesions that usually appear on the skin. They also can appear on the lymph nodes, mouth, gastrointestinal tract and lungs.

Shingles – Shingles are caused by a reactivation of the chicken pox virus. It may cause a painful rash or blisters that follow the path of nerves.

There are actually side effects to almost all new medications, so it’s not uncommon to feel aches and pains, headaches, stomachaches, or fatigue for a few days (up to a maximum of a month). 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 (fat redistribution); insulin resistance (which can lead to blood sugar level abnormalities and, possibly, diabetes); increases in cholesterol or triglycerides (which affects 3-5 percent of certain medication users); decreases in bone density (which can increase your risk of fractures), and lactic acidosis (which can lead to everything from muscle aches to liver failure).

Also, the U.K. HIV group Avert points out that not all drugs have the same side effects so “for example, efavirenz is the drug most associated with psychiatric symptoms, while protease inhibitors are more likely to raise levels of cholesterol and triglycerides.” So what works for one person might make the other person sick, and if there are other existing health issues like high blood pressure, diabetes, anxiety disorders, or hepatitis, those can increase the risk of certain side effects.

Bottom line: They are rarely severe, but if you have any side effect longer than a few weeks, don’t just assume you have to just put up with it; ask your doctor about it.

Adherence and dealing with side-effects of antiretroviral treatment for HIV

FAST FACTS

  • Antiretroviral treatment (ART) reduces the level of HIV in your blood so that it cannot damage your immune system.
  • If you do not take your medication correctly (at the right time every day), the level of HIV in your blood may increase and the treatment may stop working. This is known as developing drug resistance.
  • Regular blood tests will show if your treatment is working by measuring the level of HIV in your blood (viral load) and the strength of your immune system (CD4 count).
  • If you have side effects that do not go away or your treatment stops working, your healthcare professional can advise you to change to a different combination of antiretroviral (ARV) drugs.

Once you start taking HIV treatment, it’s important that you take it every day. Your healthcare professional will explain how many pills to take, how often to take them, and whether you should take them with food.

It is your right to choose whether to take HIV treatment, when to start and whether to stop, but you should never simply stop taking your treatment. If you have any problems, questions or concerns about your treatment or health, talk to your healthcare professional and they will be able to help you make an informed decision.

Why is it so important to take my medication every day?

ARV drugs keep HIV under control, but they don’t stay in your body for a long time, so you have to keep topping them up.

If you stop taking your HIV drugs, then your viral load will go up. This means HIV can damage your immune system, and that you are more likely to pass HIV on.

If you regularly miss doses of your HIV treatment, there is a risk that the HIV in your body will become resistant to the medication and the drugs will no longer work even when you do take them.

So, it is important to take your treatment correctly – the right dose, at the right time, with or without food. There are many ways you can get help to remember to take your treatment every day (this is known as adherence).

If you know there will be a change to your normal routine – for example if you are going to be staying away from home – then plan what you can do to keep taking your treatment on time. For example, you may find it helpful to set an alarm on your phone and carry extra ARVs in case you are delayed.

Most people forget to take their treatment once in a while. However, if you find you often forget, then talk to your healthcare professional honestly about it. If they know you are having problems, they can offer support and advice before your treatment stops working.

How can I tell if my treatment is working?

Regular blood tests will show how well your treatment is working. The main blood test used to monitor how your body is responding to treatment measures the viral load (how much of the HIV virus is in your blood).

The aim of HIV treatment is to lower your viral load and then to keep it as low as possible. When your viral load is very low, it is not possible for tests to measure it. This is a really good result, your viral load is called undetectable. You still have HIV, but it is being kept under control by the HIV treatment. Not only should you feel healthy, but if your viral load is undetectable, you cannot transmit HIV.

WHO recommends that you have a viral load test at 6 and 12 months after you start taking treatment, and then once every year. If treatment is begun early enough and followed correctly, your viral load can become undetectable within 6 months.

The other main blood test is a CD4 count, which shows the strength of your immune system. CD4 cells, an important part of your immune system, are attacked by the HIV virus. When you start taking treatment the numbers of CD4 cells you have (your CD4 count) will go up and if you were feeling ill because of HIV, you should start to feel better.

In some countries, viral load testing is not available. If this is the case where you are, your healthcare professional will monitor your health and your CD4 count in other ways.

My HIV treatment has side-effects. What can I do?

Many people experience some mild side-effects, particularly in the first few days and weeks of starting treatment. For example, you might feel sick or have a headache. Although unpleasant, most side-effects should improve and go away altogether as your body gets used to taking the drug.

Some side-effects may be less obvious to you. For example, the commonly used drug TDF (tenofovir) can cause problems with the kidneys. Your healthcare professional will check a sample of your urine to look out for early signs of kidney problems.

If you think you are experiencing a side-effect, the best thing you can do is talk to a healthcare professional about it. They can advise you what to do and may prescribe something for you to take for a short period, such as an anti-nausea drug. If a side-effect doesn’t go away and is affecting your quality of life, you should be able to change to a different drug.

Could my treatment stop working?

For many people, the treatment they start taking will continue to work for as long as they take it.

If your viral load is not being kept under control by the treatment you are taking, your healthcare professional will want to find out why. It may be that you are having problems taking the drugs correctly, that they do not interact well with other drugs that you are taking or that your virus has become resistant to them.

Your healthcare professional may be able to help you resolve the problem and stay on the same treatment. However, if your treatment has stopped working, perhaps because of drug resistance, then you will be advised to change treatment. There are a number of HIV drugs, so your healthcare provider should be able to find a combination of drugs that is effective for you.

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What Is HIV Treatment?

HIV treatment involves taking medicines that slow the progression of the virus in your body. HIV is a type of virus called a retrovirus, and the combination of drugs used to treat it is called antiretroviral therapy (ART). ART is recommended for all people living with HIV, regardless of how long they’ve had the virus or how healthy they are. ART must be taken every day, exactly as your health care provider prescribes.

Why Is HIV Treatment Important?

Getting and staying on HIV treatment because it reduces the amount of HIV in your blood (also called the viral load) to a very low level. This keeps you healthy and prevents illness. There is also a major prevention benefit. People living with HIV who take HIV medication daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners. This is called treatment as prevention.

If left untreated, HIV attacks your immune system and can allow different types of life-threatening infections and cancers to develop. If your CD4 cell count falls below a certain level, you are at risk of getting an opportunistic infection. These are infections that don’t normally affect people with healthy immune systems but that can infect people with immune systems weakened by HIV infection. Your health care provider may prescribe medicines to prevent certain infections.

HIV treatment is most likely to be successful when you know what to expect and are committed to taking your medicines exactly as prescribed. Working with your health care provider to develop a treatment plan will help you learn more about HIV and manage it effectively.

When Should You Start HIV Treatment?

Treatment guidelines from the U.S. Department of Health and Human Services recommend that a person living with HIV begin ART as soon as possible after diagnosis. Starting ART slows the progression of HIV and can keep you healthy for many years.

If you delay treatment, the virus will continue to harm your immune system and put you at higher risk for developing opportunistic infections that can be life threatening.

Does ART Cause Side Effects?

Like most medicines, antiretroviral therapy (ART) can cause side effects. However, not everyone experiences side effects from ART. The HIV medications used today have fewer side effects, fewer people experience them, and they are less severe than in the past. Side effects can differ for each type of ART medicine and from person to person. Some side effects can occur once you start a medicine and may only last a few days or weeks. Other side effects can start later and last longer.

If you experience side effects that are severe or make you want to stop taking your HIV medication, talk to your health care provider or pharmacist before you miss any doses or stop taking the medication. Skipping doses or starting and stopping medication can lead to drug resistance, which can harm your health and limit your future treatment options.

Some side effects of ART that are most commonly reported include:

  • Nausea and vomiting,
  • Diarrhea,
  • Difficulty sleeping,
  • Dry mouth,
  • Headache,
  • Rash,
  • Dizziness,
  • Fatigue, and
  • Pain.

And be aware; HIV medicines also may cause different side effects in women than men.

Contact your health care provider or pharmacist immediately if you begin to experience problems or if your treatment makes you sick. If side effects make you want to skip taking your medications sometimes or stop taking them altogether, talk to your health care provider or pharmacist right away to find solutions that work for you. Your health care provider may prescribe medicines to reduce or eliminate side effects or may recommend changing your medication to another type of ART that might work better for you. Learn more about the possible side effects of ART and ways to manage them.

What Is HIV Drug Resistance?

Drug resistance can be a cause of treatment failure for people living with HIV. As HIV multiplies in the body, it sometimes mutates (changes form) and produces variations of itself. Variations of HIV that develop while a person is taking ART can lead to drug-resistant strains of HIV.

With drug resistance, HIV medicines that previously controlled a person’s HIV are not effective against new, drug-resistant HIV. In other words, the HIV medicines can’t prevent the drug-resistant HIV from multiplying. Drug resistance can cause HIV treatment to fail.

A person can initially be infected with drug-resistant HIV or develop drug-resistant HIV after starting HIV medicines. Drug-resistant HIV also can spread from person to person. Drug-resistance testing identifies which, if any, HIV medicines won’t be effective against your specific strain of HIV. Drug-resistance testing results help determine which HIV medicines to include in an HIV treatment regimen.

Taking HIV medication every day, exactly as prescribed helps prevent drug resistance. Read more about drug resistance in this fact sheet from AIDSinfo.

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HIV treatment side-effects and mental health

Key points

  • Small numbers of people talking efavirenz, dolutegravir and rilpivirine have experienced side-effects affecting their mood or mental health.
  • These may include depression, anxiety, sleeplessness, vivid dreams, and dizziness.
  • These side-effects are more likely to occur if you have had mental health difficulties in the past.

Some anti-HIV drugs can affect your emotional and mental health. Some people have problems with depression, anxiety, sleeplessness, vivid dreams and dizziness. Most notably, this affects small numbers of people taking the following drugs:

  • efavirenz (Sustiva, also in the combination pill Atripla)
  • dolutegravir (Tivicay, also in the combination pills Triumeq, Juluca and Dovato)
  • rilpivirine (Edurant, also in the combination pills Eviplera, Odefsey and Juluca).

The largest number of problems occur in people taking efavirenz. For this reason, the British HIV Association no longer recommends efavirenz as a ‘preferred’ drug to start HIV treatment with.

People with a history of mental health problems may be more likely to have difficulties if they start taking one of these drugs. It is important you tell staff at your HIV clinic if you’ve had depression or other problems in the past, before you start HIV treatment. In particular, if you do have previous experience of depression, efavirenz might not be a good choice for you.

Often the emotional troubles and sleep problems associated with these drugs lessen or go away completely within a few weeks of starting this treatment. But for some people they become a long-term side-effect. In this case, there are likely to be other equally effective treatment options available to you. Ask your clinic staff for advice on these.

Anti-HIV drugs can also affect your emotional wellbeing by causing side-effects such as pain, nausea and vomiting, or diarrhoea. Most side-effects are generally mild and lessen or go away over time. Furthermore, it’s nearly always possible to do something about side-effects. There are now over 20 anti-HIV drugs available, and it’s often possible to change to a drug that doesn’t cause the side-effect you find problematic.

Some older anti-HIV drugs can cause changes in body shape through fat loss or fat gain (a condition called lipodystrophy). While the use of these drugs is now avoided, you may have taken them in the past and still be living with changes in body shape. If this has affected your self-confidence or self-esteem, ask at your clinic to see a counsellor or psychologist to discuss them.

9 Facts About Current HIV Treatment

Medically reviewed by C. Fookes, BPharm Last updated on Mar 20, 2018.

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1. Nearly 40,000 people still get HIV every year in the US

Although the number of new cases of HIV declined by 5% from 2011 to 2015, there were still 39,782 people diagnosed with HIV in 2016.

Targeted HIV prevention efforts may explain the decrease; however, there does appear to be a true decline in infections. Gay and bisexual men account for 67% of all HIV diagnoses and 83% of diagnoses among males. Nearly 40% of gay and bisexual men diagnosed with HIV were African American and nearly 30% were Hispanic/Latino.

Unprotected sex is still the most common way to get HIV, followed by sharing injection drug equipment. But it is easy to protect against HIV. Use condoms correctly every time you have sex. Don’t inject drugs. If you do, use only clean needles and equipment and don’t share your equipment with others. Ask your doctor about taking Truvada to further reduce your risk of getting HIV.1, 2

2. HIV doesn’t have to be a terminal illness

Thirty-five years ago the world was just becoming aware of a new syndrome experts called the Acquired Immune Deficiency Syndrome AIDS or AIDS. They had no idea what caused it, how it spread or what to treat it with. People diagnosed with HIV in the early 1980’s were lucky to survive 8 years.

But 30 years of dedicated research brings results. There are dozens of different drugs available now to treat the HIV virus. If these drugs are started early, taken exactly as recommended by a doctor, and give good viral suppression, then the chances of developing AIDS are dramatically reduced.

In fact, people with HIV are likely to have a lifespan generally the same as uninfected people and are more likely to die of other causes, such as heart conditions or cancer. 3,4

3. Strict adherence to HIV treatment is key

The treatment of HIV is different to the treatment of other chronic diseases, like diabetes and hypertension. For these diseases, drug regimens remain effective even after treatment is resumed following a period of interruption.

Not so for HIV. Forgetting or choosing not to take your HIV medication may lead to the emergence of drug resistance which is a major cause of treatment failure.

Consistently taking your medicine each day and every day will increase your chances of living a long and healthy life free from AIDS. 4

4. Truvada reduces the risk of injection drug users and uninfected partners acquiring HIV by up to 92%

Truvada is recommended by the FDA for reducing the risk of acquiring HIV sexually, or via injection drug use, in both men and women (Pre-exposure Prophylaxis, or PrEP).

Truvada contains a fixed combination of tenofovir and emtricitabine and must be taken daily. It works to keep the virus from establishing a permanent infection and should be used with other prevention methods (such as condoms).

It is much less effective when not taken consistently.5 Truvada is also used as an HIV treatment along with other medicines.

5. HIV medicines prevent mother-to-child transmission of HIV

It is important pregnant women with HIV continue to take their HIV medication as prescribed by their doctor.

Most HIV medicines are safe to use during pregnancy. HIV medicines slow down the growth and multiplication of the HIV virus in the body. Having less HIV in the body lowers a woman’s chance of passing the HIV virus to her child during pregnancy and childbirth, and helps to keep the woman healthy, too. Babies born to women with HIV also receive HIV medicine for 4 to 6 weeks after birth. The HIV medicine reduces the risk of infection from any HIV that may have entered a baby’s body during childbirth.6,7

6. Condoms should still be used during pregnancy

Condoms not only protect against pregnancy, they also protect against HIV and other sexually transmitted infections.

Women who are pregnant are at higher risk of getting HIV than women who are not pregnant. This means that your unborn baby is also at a very high risk of acquiring the disease. So it’s important to still use condoms when you are pregnant, and if your partner has HIV, ask your doctor about taking Truvada which offers further protection for you and your baby. 6

7. Know that if one regimen doesn’t suit, there are other options

There are many different types of medicines used in various combinations to treat HIV. Newer HIV drugs have far fewer side effects than older HIV drugs, and experts have named a few “recommended regimens” based on how effective a drug is, how many side effects it has and how often it needs to be administered (ie, once daily administration versus multiple daily administration).

If you are new to HIV treatment, your doctor will probably start you on one of these recommended regimens. But know that there are alternatives which your doctor can discuss with you if you find that particular regimen hard to tolerate. 4

In March 2018, Trogarzo (ibalizumab-uiyk) was approved by the FDA. This is a welcome addition for people who have multidrug-resistant HIV and who have run out of other treatment options. Trogarzo is given once every 14 days by injection in addition to other antiretroviral drugs.

8. Generic formulations may save you money

The most important thing you can do if you have HIV is to take your medication every day. However, for some people, the high cost of HIV treatment gets in the way, particularly if their insurance does not cover the full amount of the drug, or if they have no insurance.

Generic versions of HIV drugs can be up to 30% cheaper than the branded version. Sometimes this may mean taking a few more pills each day, generics of all products may not be available, but it may be worth it. Just be sure to take your medicine without fail.

Talk to your doctor about the cost of your regimen, and if there are any cheaper alternatives. 4

9. Living with HIV doesn’t mean a lifetime of monitoring

If you have HIV, you learn to live with it, but having to go for regular blood tests can get in the way of leading your life.

Experts now agree that if you have been taking your HIV combination treatment for at least 2 years, with consistent viral suppression, and your CD4 counts are >500 cells/mm3 then monitoring is optional. If your CD4 count remains between 300 and 500 cells/mm3 then regular monitoring every 12 months is still recommended. 4

See Also

  • AIDS and HIV Overview
  • HIV and AIDS Opportunistic Infections and Symptoms
  • HIV and AIDS Treatment: Drugs and Classes
  • HIV and AIDS: Opportunistic Infections, Complications and Treatments
  • HIV Prevention: PrEP and Other Options
  • National HIV Testing Day

Sources

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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