Standard dosing chart for anti-HIV drugs

January 2006     View PDF     En español

General concerns about anti-HIV drugs

Lipodystrophy
A side effect that may be related to anti-HIV therapy is body composition changes or changes in fat distribution, called lipodystrophy. This might include fat loss in areas (lipoatrophy) or fat accumulation in others (lipohypertrophy). This includes fat loss in the face (sunken cheeks); loss of fat in the arms and legs; loss of shape in the buttocks; breast enlargement; fat pad in the back of the neck (sometimes called buffalo hump); and increase in fat around the gut (sometimes called central or truncal obesity or protease paunch). Possible related side effects include changes in laboratory measures of how the body processes fats and sugars. This includes changes in cholesterol, triglyceride and blood glucose levels.

Mitochondrial toxicity
Mitochondrial toxicity is a side effect that may be caused by the anti-HIV drugs called NRTIs. Symptoms can include muscle cell destruction and weakness (myopathy), numbness and tingling in fingers and toes (peripheral neuropathy), and inflammation of the pancreas (pancreatitis). One potentially life-threatening outcome of this condition is lactic acidosis, a result of abnormally high levels of lactate in the body’s cells. In early stages of lactic acidosis, people experience muscle weakness, shortness of breath, nausea, vomiting and pain in the gut. Another outcome of mitochondrial toxicity is hepatic steatosis, or “fatty liver”, and often leads to lactic acidosis.

Bone problems
Other side effects that anti-HIV therapy may cause are bone complications, including avascular necrosis and osteonecrosis. These are caused by a lack of blood supply in the bone that leads to deterioration and death of bone tissue. This may then lead to the bone fracturing or collapsing.

Publications
For more information on these topics, read Project Inform's publications, Lipodystrophy Syndrome(s), Mitochondrial Toxicity and Lactic Acidosis, Bone Complications, and Drug Interactions.