Strategies for third line HIV therapy

May 2008     View PDF     En español

Treatment failure due to side effects

Unfortunately, side effects can go hand-in-hand with the getting benefits of being on HIV therapy. Some may moderately impact your quality of life or they may only last a short time. Before you switch your HIV drugs, it can help rule out their possible causes or consider ways to manage them. (Project Inform’s publication, Dealing with Drug Side Effects, offers helpful tips.)

Deciding what to do about other side effects, like elevated cholesterol and triglycerides, insulin resistance and fat redistribution, can be more challenging. Since many people have limited treatment options, switching from the offending drugs simply isn’t an option. In this case, the choice may be to switch to a regimen which includes drugs they’ve used before that carry fewer risks for these side effects until other drugs become available.

If you’ve had side effects with a drug or regimen in the past, it does not necessarily mean you can’t use it again. Some people find that a drug that had caused them unacceptable side effects before actually causes them no side effects whatsoever when they used it again.

Similarly, it can be difficult to know which drug in your regimen was the culprit for a given side effect. If you’re taking four drugs, you might be able to use two or even three of them again with no ill effects.

It’s also sometimes very difficult to sort out drug side effects from the symptoms of HIV disease. Did a drug cause your diarrhea or was it caused by HIV or something else altogether? As long as the drug can be used safely again, it might still stay in your toolbox of options. It might take some mental preparation and planning in case the side effect re-emerges. But in general, having stopped a drug because of side effects doesn’t always rule it out for future use.

Research shows that people with lower CD4 counts are more likely to experience side effects, and they tend to be more severe. Therefore, if you started a drug regimen in the past when your CD4 count was lower than now, you may be less likely to experience trouble.