Education, advocacy, training
Treatment training for advocates
Questions and answers
4 Side effects of ARVs
Answers
1. What are side effects?
Side effects are when a drug affects your body in other, unwanted ways besides treating an illness. Side effects are also called adverse events or drug toxicity.
2. Are side effects different in men and women?
In some cases they are, but generally there is not a big difference.
One of the most important differences is with nevirapine and liver toxicity. Women should not start treatment with nevirapine if their CD4 count is over 250, compared to men who should not start if it their count is over 400.
3. Is it possible to stop or change your treatment because of side effects? If so, why would you do this?
Both of these options are possible, but not without a discussion with the doctor. Quality of life is very important, and any drug that causes side effects can usually be changed to an alternative that may be easier to tolerate.
4. How are side effects graded?
From grade 1 (mild) to grade 4 (severe).
5. What is the difference between lipodystrophy and lipoatrophy?
Lipodystrophy refers to the way the body processes fats and sugars (lipo = fat, dystrophy = in the wrong place). Lipodystrophy symptoms include fat loss in your arms, legs or face, or fat gain in abdomen, breasts and shoulders and increased blood cholesterol and triglycerides.
Lipoatrophy refers just to subcutaneous fat loss – fat loss under the skin in your arms, legs or face (lipo = fat, atrophy = loss).
6. What is peripheral neuropathy?
Peripheral neuropathy is damage to the nerves in the hands or feet. It starts with tingling, numbness or increased sensitivity in the fingers and/or toes. If peripheral neuropathy is allowed to develop it can become very painful and permanent and move up your limbs.
7. Which ARVs are most commonly associated with peripheral neuropathy?
d4T, ddI and rarely 3TC.
8. Which ARV is most commonly associated with anaemia?
AZT.
9. Which ARVs are most commonly associated with liver toxicity?
Nevirapine and efavirenz.
10. Name 2 symptoms of liver toxicity.
Symptoms of liver toxicity include:
- feeling sick (nausea) or being sick (vomiting)
- poor appetite
- more yellow eyes or skin (jaundice)
- light coloured stool or dark coloured urine
- tenderness or swelling in your liver – your liver is just below your stomach
11. Which ARVs are most commonly associated with serious rash?
WHO recommended ARVs: nevirapine, efavirenz and abacavir.
Other ARVs: fosamprenavir and T-20.
12. How is a severe rash defined?
A rash is severe if it covers more than 10% of the body or if it breaks the skin.
It is a good idea to show any rash to a doctor or health advisor as soon as you notice it if you have recently started a drug that can cause this side effect.
13. Give an example of a grade 2 side effect and a grade 4 side effect.
Any side effect that requires hospitalisation is classified as grade 4.
14. When is the risk of lactic acidosis higher?
The risk of lactic acidosis increases when d4T is used with ddI. These two drugs should not be used together by pregnant women as the risk increases even more.
15. Which ARV is associated with mood changes, nervousness and strange dreams?
Efavirenz. Most people experience mood changes and vivid dreams when they start taking efavirenz. These usually subside after a few weeks.
Training manual authors | Training manual copyright policy | Full section index
Top | Home | Manual | Order & subscribe | Contact | Site map | Access
Last updated on Monday 26th November 2007.
