Antiretroviral Therapy Adverse Effects in HIV Treatment
Summary
Since the adoption of combination antiretroviral therapy, life expectancy for people living with HIV has increased markedly. However, long-term suppression of viral replication with nucleoside reverse transcriptase inhibitors, non-nucleoside inhibitors, protease inhibitors and integrase inhibitors can provoke a spectrum of adverse effects. These range from acute gastrointestinal disturbances, dermatological reactions and hypersensitivity to chronic metabolic complications such as dyslipidaemia, insulin resistance, mitochondrial toxicity and lipodystrophy. Haematological toxicity, notably anaemia and neutropenia, has been associated with early regimens, while newer agents carry risks of renal impairment and neuropsychiatric events. Such effects may undermine adherence, precipitate regimen changes and erode quality of life, especially in resource-limited settings. Identification of host factors—age, sex, comorbid conditions and concomitant medications—alongside pharmacogenetic profiling, is central to optimising safety. Ongoing development of agents with improved pharmacokinetic and toxicity profiles, supported by vigilant clinical monitoring and patient education, offers a pathway to mitigate adverse reactions without compromising therapeutic efficacy.
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Antiretroviral Therapy Adverse Effects in HIV Treatment publication trend
The graph below shows the total number of articles in antiretroviral therapy adverse effects in hiv treatment across all publications each year (not limited to Nature Index journals).
Technical terms
Adverse drug reaction (ADR): An unintended and harmful response to a medication administered at standard doses.
First-line regimen: The initial combination of antiretroviral agents selected for HIV treatment according to clinical guidelines.
Dyslipidaemia: An abnormal increase in blood lipid levels often linked to long-term antiretroviral use.
Mitochondrial toxicity: Cellular injury caused by interference with mitochondrial DNA replication, leading to energy deficits in tissues.
Incidence density: A measure of the frequency of new adverse events occurring in a population over a specified period.
References
- Time to First Line Antiretroviral Therapy Adverse Drug Reaction and its Predictors Among Adult HIV/AIDS Patients on Treatment in Eastern Ethiopia. Frontiers in Pharmacology (2022).
- Magnitude and causes of first-line antiretroviral therapy regimen changes among HIV patients in Ethiopia: a systematic review and meta-analysis. BMC Pharmacology and Toxicology (2019).
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