Although drugs are designed to work against specific illnesses, they sometimes interfere with other ways that your body works. The current drugs available to treat HIV are far from perfect and some do cause side effects.

Most drugs have side effects of some sorts, although usually they are mild and easily manageable. Sometimes side effects are so mild that they are rarely noticed. Sometimes side effects only become apparent after the drugs have been in use over a longer period. All drugs have side effects, but not all people taking drugs will experience the same effects and to the same extent.

The leaflet included with your drugs will list all the reported range of possible side effects associated with each drug.

Risk of side effects can be a big worry if you are about to start HIV treatment for the first time. It will help if you know what to expect from different drugs before choosing your combination. Ask for information about each of the drugs you might take, including the possible side effects. For example, what percentage of people had side effects related to those drugs and how serious they were?

If starting treatment for the first time, you will have a lot of choice of combinations of drugs that work and are tolerable. There are already over 14 HIV drugs, and while you can’t mix and match them all, you have a lot of choice in how they are used. If you find one or more of the drugs in your combination difficult to tolerate, you can change it for another. The fewer drugs you have used previously, the more choice you have to change. If you change a drug because of the side effects, you can usually go back and use it later if you need to (except for abacavir). Sometimes side effects improve after the first few weeks or months, but sometimes they don’t. You do not have to continue with a drug to prove anything to yourself or to please your doctor. If you know something is wrong, ask your doctor to change it to something else. Some drugs are just not for everyone.

Yes. Women have shown higher rates of side effects in some nevirapine studies (both liver toxicity and rash). With lipodystrophy (changes related to fat distribution), women are more likely to report symptoms of fat accumulation rather than fat loss.

Unfortunately some doctors generally think that people overestimate and exaggerate side effects. It is also true that most people actually underestimate side effects. People generally say that side effects are less inconvenient or less difficult than they really are, or often forget to mention them at all.

This means there can be a big difference between what is actually going on and what doctors think is going on – and this is why side effects are often under treated. Therefore it is important that when attending your doctor you report on all the side effects you are experiencing.

Usually there are. Most side effects reduce or disappear with time. If the first treatment you are given to help with a side effect does not work, there are usually others that you can use that may be more tolerable.

This booklet lists a range of options, including alternative treatments, for each of the main symptoms. If one doesn’t work – try the other options. Changing or stopping treatment are important options that you can discuss with your doctor.

If your quality of life is very bad because of the side effects, you may chose to look at experimental strategies like treatment interruption or immune-boosting treatment such as IL-2.