Strategies for HIV therapy

April 2008    View PDF    En español

Quality of life issues

Your ability to tolerate side effects, drug interactions and the demands of a regimen can be as important as the potency of a drug. If you can’t take a drug as prescribed, its potency is irrelevant. Not adhering to therapy contributes to developing drug resistance, and developing resistance to one drug might lead to cross-resistance to other drugs in the same class.

When choosing therapy, consider the daily pill count of everything you take. These include the HIV drugs, drugs to prevent and treat other infections or conditions, supplements, etc. Consider when they have to be taken and whether or not they can be taken with other medicines or food. It’s easiest to combine drugs that require similar conditions, such as with or without food. Otherwise, one’s life can become dominated by drug schedules.

It’s also best to avoid mixing drugs with similar side effects, though sometimes that is impossible. It’s critical to learn about the possible side effects of each drug that you take as well as possible drug interactions before mixing them together. To help better understand these issues, read Project Inform’s publication, Dealing with drug side effects, as well as materials on each HIV drug.

Not everyone experiences side effects. Learning about possible side effects and drug interactions before starting therapy allows you to be aware of what to check for and to consider ways to prevent or manage them, before they happen. The more informed you are, the less likely you will come across severe or life-threatening side effects. Also, the more prepared you are, the less likely that side effects and drug interactions will interfere with adhering to your regimen.

One side effect of particular concern is changes in body composition and metabolism, generally called lipodystrophy. They include fat accumulation (lipohypertrophy) and/or fat loss (lipoatrophy) and/or changes in lab values of fats (dyslipidemia) or sugars/insulin (diabetes). Some HIV drugs contribute to these conditions more than others.

Another condition, impacting the energy source inside cells (mitochondrial toxicity), is particularly associated with using NRTIs (see Drug ID Chart). Also, reports of people experiencing bone loss are increasing. All of these conditions may result from long-term use of HIV therapy. For more information, read Project Inform’s publications, Bone Health and HIV Disease and Mitochondrial Damage and Lactici Acidosis.