Adverse effects of antiretroviral therapy for HIV infection

• Published in: Canadian Medical Association journal 2004-01, Vol.170 (2), p.229-238
• Main Authors: Montessori, Valentina, Press, Natasha, Harris, Marianne, Akagi, Linda, Montaner, Julio S.G
• Format: Article
• Language: English
• Subjects: Anti-HIV Agents - adverse effects; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active - adverse effects; Antiretroviral Therapy, Highly Active - methods; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Drugs; Female; Follow-Up Studies; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - mortality; Human immunodeficiency virus; Humans; Hyperglycemia - chemically induced; Hyperglycemia - epidemiology; Hyperlipidemias - chemically induced; Hyperlipidemias - epidemiology; Incidence; Lipodystrophy - chemically induced; Lipodystrophy - epidemiology; Liver Diseases - epidemiology; Male; Osteonecrosis - chemically induced; Osteonecrosis - epidemiology; Physiological aspects; Randomized Controlled Trials as Topic; Review; Risk Assessment; Skin Diseases - chemically induced; Skin Diseases - epidemiology; Survival Analysis; Treatment
• ISSN: 0008-4409; 0820-3946; 1488-2329

Long-term remission of HIV-1 disease can be readily achieved by combinations of antiretroviral agents. The suppression of plasma viral loads to less than the limit of quantification of the most sensitive commercially available assays (i.e., less than 50 copies/mL) and the coincident improvement in CD4 T cell counts is associated with resolution of established opportunistic infections and a decrease in the risk of new opportunistic infections. However, prolonged treatment with combination regimens can be difficult to sustain because of problems with adherence and toxic effects. All antiretroviral drugs can have both short-term and long-term adverse events. The risk of specific side effects varies from drug to drug, from drug class to drug class, and from patient to patient. A better understanding of the adverse effects of antiretroviral agents is of interest not only for HIV specialists as they try to optimize therapy, but also for other physicians who care for HIV-positive patients.