Side Effects of Antiretroviral Drugs

The Centers for Disease Control and Prevention report that over 1.1 million Americans had the human immunodeficiency virus (HIV) as of 2006. HIV is a virus that affects the immune system, hampering your ability to fight off infections that often leads to the development of the often fatal AIDS virus. There are no cures for HIV and AIDS; however, several prescription antiretroviral drugs are available to decrease the spread of HIV throughout the body. While these drugs extend lives, they also carry risks for side effects, the seriousness of which vary between the types of antiretroviral drugs.

Nucleoside Reverse Transcriptase Inhibitors

• Nucleoside Reverse Transcriptase Inhibitors or NRTIs prevent HIV from further infecting immune system cells by stopping the virus' replication. Some side effects of NRTIs last only a maximum of 6 weeks, such as fatigue, headache and loss of appetite. Other more rare side effects develop during long term use of NRTIs. An example is lactic acidosis, a complication where your blood becomes too acidic, damaging body cells. NRTIs also cause fat to build up around the liver, resulting in a condition called hepatic steatosis. Another troubling side effect of NTRIs is the redistribution of body fat from the limbs and buttocks to form unsightly lumps of fat in other regions, such as the back of the neck.

Nonnucleoside Reverse Transcriptase Inhibitors

• Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs) function similarly to NRTIs, but disrupt the replication process using a different mechanism. NNRTIs frequently cause drowsiness, dizziness and confusion during the first 2 to 4 weeks of treatment. There is also the potential of serious skin rashes at 6 weeks such as Stevens-Johnson syndrome. This skin infection requires immediate medical attention to avoid permanent marring of the skin or damage to the heart, lungs, kidney or liver.

Protease Inhibitors

• Protease inhibitors (PIs) block enzymes necessary for HIV cell reproduction. Because PIs increase the likelihood of bleeding, doctors do not prescribe them for hemophiliacs. PIs also have the potential to increase levels of fat or triglycerides in your blood stream and to cause the redistribution of fat similarly to NRTIs. In addition, PIs often cause the onset of diabetes or uncontrolled amounts of sugar in the blood. Usually, symptoms of diabetes begin 10 to 11 weeks after beginning PI usage. Rarely, PIs cause problems with liver function, putting patients at risk for developing hepatitis.

Fusion Inhibitors

• Fusion inhibitors prevent HIV cells from entering cells in the immune system, slowing the spread of the virus. Unlike oral antiretroviral drugs, patients inject fusion inhibitors directly into the bloodstream. Often, the injection site becomes irritated from the drug, resulting in cysts or bumps on the skin. Fusion inhibitors often cause a reduction in infection-fighting white blood cells, increasing the chance of illnesses such as pneumonia.

Chemokine Coreceptor Antagonists and Integrase Inhibitors

• Chemokine coreceptor antagonists (CCAs) fight HIV cells by affecting parts of viral cells necessary for invading body tissues, while integrase inhibitors (IIs) stop the process of HIV DNA replication within immune system cells. Minor side effects of both CCAs and IIs include diarrhea, nausea, fatigue, dizziness and joint pain. CCAs increase the chance of contracting upper respiratory infections, causing congestion, cough and difficulty breathing. IIs often calls abnormal dreams as well as an itchy rash. In addition, both classes of drugs have effects upon the liver that mimic the actions of protease inhibitors.