When side-effects develop

Most side-effects occur after you have been taking a medicine for a week or two. However, there is no strict pattern, and some people develop side-effects after taking their first dose of a drug. For others, side-effects don’t develop for many months.

Side-effects occur in the first month or so of taking a drug not because you are being poisoned by the medicine, but because your body is adjusting to the drug. In other cases, it can be that you have especially high concentrations of a drug in your blood in the weeks and months after you first start taking it. Over time, the peak drug levels in your blood go down, and side-effects tend to wear off. Because of this, it might be recommended in some cases that you gradually increase the dose of a drug you take over a few weeks.

Side-effects are often worse during the first month or so of taking a drug. Over time, they may lessen, modify, or go away altogether.

There can be a daily pattern to side-effects, linked to the time you take your medicines and also to the processing of the drug by your body. It might be possible to minimise the inconvenience that this causes by taking your medicines at certain times. For example, the non-nucleoside reverse transcriptase inhibitor (NNRTI) efavirenz (Sustiva, also in the combination pill Atripla) can cause dizziness and other psychological side-effects. Many people overcome these by taking their daily dose of the drug just before going to bed.

Medicines are available to help control side-effects in the short-term. These include pain killers and other headache pills, as well as anti-sickness and anti-diarrhoea drugs.

Some people find that mint tea can help reduce feelings of being sick, and that simple changes in diet can also help, such as avoiding fatty or greasy food if you are feeling sick.

It’s also known that some side-effects only develop in the longer term. For example, some anti-HIV drugs can cause liver or kidney problems. Increased levels of blood fats have also been seen in some people taking HIV treatment and this can increase the long-term risk of illnesses like heart disease and stroke. Some older HIV drugs (the use of which is now avoided) caused long-term changes in body shape (lipodystrophy) and painful nerve damage to the feet (peripheral neuropathy) .

A rare, but serious, long-term side-effect is called lactic acidosis.

You'll be carefully monitored at your HIV clinic to see if you have any warning sides of long-term side-effects. Sometimes you'll have the option of changing to another treatment, or it may be possible to control the side-effect with the use of other medicines.

If you have a very weak immune system when you start HIV treatment, there’s some evidence to suggest that you might be more vulnerable to side-effects.

Though it's good to remember that even though there may be a risk of side-effects, HIV treatment is very effective, and taking it will mean that you have a very good chance of living a much longer and healthier life.