Connected: Other Long-term Side Effects

These can include:

diabetes. Also modifiable with change to diet, this may be associated both with certain protease inhibitors and certain NRTIs.

kidney problems. These are rare, and particularly associated with the drug tenofovir (in Viread, Truvada and Atripla). Reversible if you are taken off the drug causing them.

liver problems. These can be caused by almost any drug, though are particularly associated with the drug DDI (didanosine – Videx).

anaemia. This is particularly associated with AZT (Zidovudine or Retrovir, also in Combivir and Trizivir). Causes fatigue, fast heartbeat, headache and can be treated with the drug EPO or by switching from AZT.

bone mineral loss (osteopenia) or bone death (osteonecrosis). People with HIV have a raised incidence of these problems. However, their cause is mysterious and it’s by no means certain yet whether they are caused by HIV medication or HIV itself. Calcium and vitamin D supplements and also drugs like bisphosphonates can help osteopenia – osteonecrosis usually only seems to happen in people who’ve taken steroids.

lactic acidosis/hyperlactataemia. One very rare but life-threatening side effect, which can occur at any time in therapy, is lactic acidosis or hyperlactataemia. The symptoms of this, a side effect of the NRTI drugs, include severe exhaustion, breathlessness, nausea and muscle aches and pain, making you will feel as if you had just run a marathon. While very rare, this is the one long-term side effect that requires urgent medical attention. If you start getting side effects like this, you should contact your clinic immediately.