Side-effects

Side-effects features

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  Efavirenz and the brain: are we nearer to solving a mysterious side-effect?

  One of the most potent HIV drugs, efavirenz, unfortunately also causes mysterious and sometimes chronic disruptions of mood, thought and sleep. Researchers may have found the key to...

  From:  HIV treatment update

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  Growing pain

  As people with HIV live longer, they are facing pains old and new. David McLay reports on peripheral neuropathy and arthritis....

  From:  HIV treatment update

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  Managing kidney disease in people living with HIV

  Part of a series on kidney disease in resource-limited settings. This edition looks at assessment and management of kidney disease in people with HIV....

  From:  HIV & AIDS treatment in practice

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  Acute and chronic kidney disease

  Part of a series on kidney disease in resource-limited settings. This edition looks at the causes and prevalence of acute and chronic kidney disease in...

  From:  HIV & AIDS treatment in practice

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  HIV and the kidneys

  It’s becoming increasingly clear that, when it comes to HIV, amongst the most vulnerable organs in the body are those two little waste filters in the small...

  From:  HIV treatment update

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  Will a long life be a good one?

  People with HIV are now living into old age – an old age many regard with fear, as Lisa Power from the Terrence Higgins Trust finds...

  From:  HIV treatment update

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  Skeleton key: a guide to HIV-related bone loss

  Many people with HIV are at risk of osteoporosis – a progressive thinning of the bones that can lead to breakage. Derek Thaczuk looks at who...

  From:  HIV treatment update

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  Body fat changes in people with HIV: a clinical review

  This article reviews the antiretroviral side-effect of lipoatrophy (fat loss) in resource-limited settings....

  From:  HIV & AIDS treatment in practice

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  Switching from efavirenz to nevirapine in women with higher CD4 counts

  This issue provides an overview of the risks and benefits, and real-life experiences, of switching from efavirenz to nevirapine in women with higher CD4 counts,...

  From:  HIV & AIDS treatment in practice

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  Peripheral neuropathy in people with HIV in resource-limited settings

  This article provides an overview of peripheral neuropathy in people with HIV, resulting from the toxic side effects of medication, diabetes or other condtions...

  From:  HIV & AIDS treatment in practice

Side-effects in your own words

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  Peripheral neuropathy – the sting in the tail

  To begin: It is estimated that between 30% and 40% of HIV patients will develop neuropathy. In the United States alone, there are 20 million sufferers (from...

  From: In your own words

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  Living with peripheral neuropathy

  I didn’t know, at first, why my feet hurt so bad. I would wake up every 90 minutes or so every night. Because of the ‘way’ they...

  From: In your own words

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  Starting treatment wasn't as scary as I thought!

  I started learning about HIV treatment soon after I was first diagnosed. I had ‘the chat’ with someone, after I got my results – I...

  From: In your own words

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  Getting into the habit

  I try to take my HIV drugs at the same time every day, just before bed. I used to set an alarm on my mobile,...

  From: In your own words

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  Holiday hassles and HRT

  A much-needed holiday. Tickets, passports, driving licence – all go in my hand luggage. I leave the toiletry bag out till the last minute. I...

  From: In your own words

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  'I just take the tablets and get on with my life'

  I was diagnosed HIV-positive in 1997. I'm now 65. It was a bit of a shock. It could never happen to me, after all. I...

  From: In your own words

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  Starting treatment

  Following my HIV diagnosis in August 2001, my doctor estimated that I would be looking to start therapy in around six years. But following a...

  From: In your own words

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  Life on HIV treatment – a personal perspective

  I’ve been taking HIV treatment for ten years – that's longer than the average life expectancy of someone with HIV when I was diagnosed back in 1991. I’ve...

  From: In your own words

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  My life with HIV

  I was born in Zambia in 1973 and came to England in April 1994 to live with my cousin to help her look after her...

  From: In your own words

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  Time will tell

  I was devastated when I got the news that I was HIV-positive. But I was lucky to have such a supportive GP. It was thanks...

  From: In your own words

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  Finally undetectable!

  After almost 15 years of HIV, and six years of viral load testing, I heard on Thursday, June 21st 2001 that my viral load had...

  From: In your own words

Side-effects news from aidsmap

• Cases of hair loss among African-American women reported after switch to new tenofovir formula

  Hair loss (alopecia) occurred in six African-American women living with HIV after switching to the new formula of tenofovir, clinicians report in Open Forum Infectious Diseases. The clinical trials that led to the approval of tenofovir alafenamide in 2015 ...

  26 June 2019 | Michael Carter

• Antiretrovirals do not cause neurodevelopmental harm to uninfected infants

  In the first five years of life the neurological development of HIV-exposed but uninfected infants, exposed to maternal antiretrovirals before and after birth and throughout breastfeeding, is comparable to that of HIV-unexposed uninfected infants from similar socio-economic backgrounds. These findings, ...

  24 June 2019 | Carole Leach-Lemens

• ART for treatment-experienced people with virological failure can omit NRTIs if three active drugs available

  Treatment for HIV-positive individuals with persistent viral replication despite therapy with multiple regimens is effective and safe over two years when it omits nucleoside reverse transcriptase inhibitors (NRTIs), provided patients have three active alternative drugs available, according to research published ...

  13 June 2019 | Michael Carter

• The impact of older antiretrovirals on fat redistribution and cardiovascular risk factors may be irreversible

  Fat redistribution in people with HIV who have ever taken thymidine analogues and/or didanosine (TA/ddI) can persist through time, while increasing cardiovascular risk factors, according to a Danish study published in the 15 March issue of AIDS. More specifically, ...

  21 March 2019 | Alain Volny-Anne

• Integrase inhibitor treatment leads to greater weight gain

  More evidence that HIV integrase inhibitor treatment is associated with weight gain, and that people gain more weight after beginning treatment with an integrase inhibitor than people taking other drug classes, was presented this week at the Conference on ...

  07 March 2019 | Keith Alcorn

• Neural tube defects and integrase inhibitors: still waiting for stronger evidence

  Researchers are still unable to determine if exposure to integrase inhibitors around conception and in early pregnancy increases the risk of neural tube defects in infants, research presented this week at the Conference on Retroviruses and Opportunistic Infections (CROI ...

  07 March 2019 | Keith Alcorn

• Efavirenz in pregnancy is at least as safe as other antiretrovirals

  An individual patient data analysis of almost 25,000 pregnancies in women living with HIV has found that the rate of birth defects following exposure to efavirenz was not statistically different, and may even be lower than in infants ...

  17 January 2019 | Roger Pebody

• Do integrase inhibitors raise the risk of obesity?

  People who take an integrase inhibitor as part of their HIV treatment appear to gain more weight than others after starting treatment and the trend is more common in women and black people, according to a review of observational ...

  10 January 2019 | Keith Alcorn

• Improved liver function, but progressive kidney damage, among children on antiretroviral therapy in Ethiopia

  Among HIV-positive children with liver and kidney abnormalities, liver enzyme abnormalities improved while kidney function progressively deteriorated the longer the children were on antiretroviral therapy (ART). With the exception of nevirapine, the specific ART regimen did not have a significant ...

  02 January 2019 | Carole Leach-Lemens

• Italian study shows growth in heart and kidney problems in people living with HIV

  Reduced kidney function, high blood pressure and cardiovascular disease have each become more common in a large cohort of Italians living with HIV followed since 2004, with a majority of people now having high cholesterol and high blood pressure, ...

  28 December 2018 | Keith Alcorn

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Side-effects news selected from other sources

• Analysis Backs New Tenofovir’s Kidney Safety Over Old Version

  Researchers compared data on more than 9,000 people with HIV who took either version of tenofovir.

  11 July 2019 | POZ

• Major HIV drug calls for vigilance

  A study lead by researchers at the Institute of HIV Research, Medical Faculty of UDE and University Hospital Essen, stumbled over a potential toxicity of integrase inhibitors. The researchers found that INSTI had a dramatic effect on activity of immune cells and in particular reduced the activity and function of CD4 T helper cells. This included a reduced proliferation and multiplication of these cells.

  24 June 2019 | University of Duisberg-Essen

• Preventing Drug Induced Liver Injury in Patients with HIV

  With an estimated annual incidence rate of 13.9 to 24 per 100,000 inhabitants, drug-induced liver injury (DILI) the leading cause of acute liver failure in the United States. It is also a unique concern in people living with HIV. Recognizing the importance of comorbid HIV and DILI, researchers from Sacco University Hospital in Milano, Italy, have published a comprehensive review of the topic ahead-of-print in the journal Pharmacological Research.

  03 June 2019 | Pharmacy Times

• A Promising Anti-HIV Drug Poses A Dilemma

  The anti-HIV drug dolutegravir is effective — but may carry a risk for pregnant women. While women in wealthy countries are given choices about their medical care, for women in poor countries the situation is different. There aren't enough doctors and nurses to explain the risks and benefits of the new drug to every patient. The country may not have the resources to keep supplies of two different drugs on the shelves. And there is no consistent access to effective birth control.

  23 April 2019 | NPR

• Weight gain with new antiretrovirals: It's complicated

  South Africa’s next big shift in our antiretroviral programme is to replace efavirenz with a newish drug called dolutegravir. The Department of Health is pleased at the prospect of a safer, more robust and, amazingly, cheaper drug. But last year, the first reports surfaced that people using it were gaining weight.

  15 April 2019 | Spotlight

• Gilead Lawsuits: 41 HIV and PrEP Patients File California Personal Injury Case Over Gilead's TDF-Based Drugs

  41 patients from 12 states nationwide who are living with HIV or AIDS or were on PrEP filed a personal injury lawsuit against Gilead Sciences Inc. seeking to hold the Bay Area drug maker accountable for actions around its failure to rectify a known defect in the drug formulation of one of its most widely prescribed medications: tenofovir disoproxil fumarate (TDF) knowing that a safer alternate, tenofovir alafenamide (TAF) existed in its own laboratory; its failure to warn patients of the damaging side effects of TDF; and the company’s active misrepresentation of TDF’s efficacy and substantial risks.

  12 April 2019 | Associated Press

• HIV Drugs With Fewer Side Effects Need More FDA Support

  New medicines providing a better quality of life should always be top priority when asking for federal support.

  27 March 2019 | HivPlusMag.com

• Inactive Ingredients in Medications Cause Trouble for Some

  Most approved medications have inactive ingredients that could cause problems for individuals with allergies or intolerances to those ingredients, researchers say. Those problems can add up when patients take more than one medication with troublesome ingredients.

  14 March 2019 | Medscape (requires free registration)

• Large French study examines neuropsychiatric side effects with integrase inhibitors

  The largest prospective study to date on integrase inhibitors and their potential for being associated with neuropsychiatric side effects was conducted in France. With more than 21,000 HIV-positive participants, the study found that the proportion of people who stopped taking integrase inhibitors due to neuropsychiatric side effects was generally very low (between 1% and 3%). Of particular note is the fact that before starting treatment with an integrase-inhibitor-containing regimen, between 3% and 10% of participants had previously reported neuropsychiatric side effects with other classes of HIV treatment.

  12 March 2019 | CATIE

• Efavirenz and psychological performance in children living with HIV

  Efavirenz remains a clinically effective and relevant antiretroviral drug for people living with HIV – but adverse side effects need to be screened for and monitored in children.

  15 February 2019 | AVERT

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