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Any drug can cause side effects, or unwanted effects.

These can be divided into different types: allergic reactions and short-term side effects; ongoing side effects; and long-term toxicities or effects which can develop over a number of years. Not everyone gets side effects from their drugs and not everyone experiences the same side effects, many are quite rare.

It’s hard to estimate how often people develop different side effects as estimates and studies show varying figures. Most anti-HIV treatments are known to cause diarrhoea, headaches and gastrointestinal upset to some degree, but these side effects are often easily managed and in most cases reduce over time. If you start treatment with a low CD4 count or high viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma., side effects may be more of an issue, and need pre-planning for effective management.

Allergic side effects or ‘adverse reactions’ to a drug are unpredictable – a few people may suffer them, but the majority won’t. Adverse reactions can occur when the immune system reacts badly to a drug and the symptoms are usually a rash or fever. Often, these symptoms will resolve themselves, but if you develop a rash when beginning a drug, seek medical advice as on rare occasions some allergic reactions can be dangerous. You may be able to treat the rash with antihistamines, or by slowly increasing your dose as your body gets used to the drug.

However, wherever a drug has been shown to potentially cause adverse reactions, it will be accompanied by a warning. Your doctor will also advise you about it, and what to do if something like a hypersensitivity rash occurs.

Direct reactions to the drugs can cause a range of, sometimes, ongoing side- effects which can vary from mild (headache or occasional diarrhoea) to more serious. There are also some problems which may develop over time, like numbing of the fingers and toes, abnormalities in liverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood. function, or abnormal redistribution of fat throughout your body. Most of these problems tend to happen with the older drugs, however. With the newer drugs, there are far fewer side effects to worry about.

Your doctor may prescribe other medicines (like anti-diarrhoea or nausea medications) to help deal with some of these. Many people report that some simple complementary therapiesA broad range of healing philosophies, approaches, and therapies that Western (conventional) medicine does not commonly use to promote well-being or treat health conditions. Examples include acupuncture, herbs, Traditional Chinese Medicine, etc. are useful in controlling side effects: talk to an HIV-experienced dietician for advice. Referrals will be available through your doctor or AIDS council treatments officer.

Some side effects to HIV drugs can develop over the long-term. Now that we know more about these drugs, doctors are increasingly monitoring and checking for signs of these problems, and may advise you to change drugs if you are at risk. These include:

• Peripheral neuropathy, or nerve damage causing pain in hands or feet;
• Blood sugar changes;
• High cholesterolAn essential component of cell membranes and nerve fibre insulation, cholesterol is important for the metabolism and transport of fatty acids and the production of hormones and Vitamin D. Cholesterol is manufactured by the liver, and is also present in certain foods. High blood cholesterol levels have been linked to heart disease and may be a side effect of some anti-HIV medications. or blood fatsA type of fat in the blood. Elevated triglyceride levels may be a side effect of some anti-HIV drugs.;
• Body shape changes like fat wasting or developing a belly, paunch or enlarged breasts (lipodystrophy);
• Muscle inflammation;
• AnaemiaA lower than normal number of red blood cells.;
• Hepatitis and pancreatitis (inflammation of the liver or pancreas); and
• Mouth ulcers.

The earlier you detect any changes, the easier it is to make changes to diet, exercise or the medications themselves, which can all help improve, or in some cases reverse these effects.

Indigo: “The treatment side effects aren’t too bad for me. I have just got used to taking them now – it’s like second nature. I don’t like the fact that I need them, but the actuality is that they’re no big deal.”

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