HIV & AIDS Health Center

Side Effects of HIV and AIDS Drugs

Severe Side Effects of HIV Drugs

Here are examples of more severe HIV drug side effects:

Lactic acidosis leads to high levels of acid in the blood, which can be fatal. It can result from the use of NRTIs.

Symptoms of lactic acidosis include:

• • Long-lasting nausea, vomiting, and abdominal pain
  • Unusual fatigue
  • Shortness of breath
  • Rapid breathing
  • Enlarged or tender liver
  • Cold or blue hands and feet
  • Abnormal heart beat
  • Weight loss

Treatment of lactic acidosis may include:

• • Changing your drug regimen, but only under the guidance of your doctor
  • Intravenous fluids, possibly in the hospital
  • Vitamin supplements

Hyperglycemia occurs with higher-than-usual levels of blood sugar, called glucose. It is a symptom of diabetes. However, you can have hyperglycemia without having diabetes. Protease inhibitors, growth hormone drugs, and hepatitis C infection can increase the risk of this side effect.

Symptoms of hyperglycemia include:

• • Increased urination
  • Excessive thirst or hunger
  • Unexplained weight loss

Treatment of hyperglycemia includes:

• • Stopping protease inhibitors, but only under the guidance of your doctor
  • Hypoglycemic drugs (to lower blood sugar) 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: 

• • A change in HIV drugs, but only under the guidance of your doctor
  • Egrifta is a drug given daily by injection. Side effects include include joint pain, redness and rash at the site of injection, stomach pain, swelling, and muscle pain. The drug may also cause increases in blood sugar.
  • Exercise and diet changes
  • Glucophage (metformin), a drug to lower high blood sugar and help reduce abdominal fat
  • Hormone treatment (such as human growth hormone), injections of fat or synthetic material, or implants

Hepatotoxicity is liver damage. It may result from several classes of HIV drugs, including NNRTIs, NRTs, and PIs. Liver damage may include inflammation, death of liver cells, or too much fat in the liver.

Symptoms of liver damage include:

• • Increased liver enzymes in the blood
  • Nausea or vomiting
  • Abdominal pain
  • Loss of appetite or diarrhea
  • Fatigue
  • Yellowing of skin and eyes (jaundice)
  • Enlarged liver