Long-term side-effects

Any long-term side-effects of taking anti-HIV drugs can take a while to become apparent, but they may have implications for your health or quality of life. Your HIV clinic will monitor these, and will be able to offer help by changing your combination of drugs, by medication and perhaps even through surgery.

Long-term side-effects can include:

• fat loss
• fat accumulation
• high blood lipids
• liver problems
• diabetes and insulin resistance
• peripheral neuropathy.

Other long-term effects may be anaemia and other blood disorders, osteoporosis, kidney problems and sexual dysfunction.

Fat loss (Lipoatrophy)

This is the loss of the fat layer under the skin that makes your limbs, buttocks and face appear wasted. Switching to a difference combination of anti-HIV drugs can help, and cosmetic remedies are available from some HIV clinics.

Fat accumulation (Lipodystrophy 1)

This is the accumulation of fat inside the abdomen, in the breasts in women and sometimes between the shoulderblades. Exercise is the best remedy for the abdominal fat accumulation, while fat between the shoulderblades can be surgically removed.

High blood lipids (Lipodystrophy 2)

Lipids is a term for any soluble fat. High levels of blood fats such as cholesterol, particularly the LDL-cholesterol associated with heart trouble, and triglycerides are found in many people taking HIV treatments. Changing your combination of anti-HIV drugs may help or lipid-lowering drugs may be prescribed by your doctor.

Liver problems

Liver problems can be caused by any HIV drug, and are much more likely in people co-infected with Hepatitis C or chronic Hepatitis B. Be nice to your liver by only drinking alcohol rarely or not at all, avoid other recreational drugs and eat a low-fat diet. You could also try complementary supplements such as milk thistle (silymarin).

Diabetes and insulin resistance

Insulin resistance, which is when your body’s ability to process sugar efficiently is reduced, is quite a common side-effect of HIV drugs. A low-carbohydrate diet and exercise may help, and you may be prescribed anti-diabetes drugs.

Peripheral neuropathy

This is damage to the nerves, particularly in the feet and, to a lesser extent, in the hands and the sacral nerves serving the genital area. Physically it feels like tingling, stabbing pains or numbness in the affected areas, and if it is severe it can make it difficult to walk. It can be hard to alleviate, but there are some treatments available.