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Who gets side-effects?

Anti-HIV drugs can cause side-effects in anyone. But that doesn’t mean that you will definitely experience side-effects – in fact many people who take HIV treatment don’t have any side-effects at all.

The type and severity of side-effects can also vary between people.

Some people find that, although they have side-effects, these are mild and they can live with them without distress or inconvenience.

Other people find that they initially experience side-effects that then become less severe or go away completely.

However, a small number of people find that side-effects are a permanent feature of a particular HIV drug and affect their quality of life, even going so far as causing physical or mental illness.

Your risk of developing some side-effects can be affected by a number of factors related to who you are.

For example, some people have a particular gene (HLA-B*5701) which puts them at risk of a severe allergic (hypersensitivity) reaction to the anti-HIV drug abacavir. There is a test to find out if you have that gene, which your doctor will arrange if you are considering treatment with abacavir. If you do have the gene, you must not take abacavir – see Hypersensitivity (allergic) reactions for more information.

Another such factor is race. For example, some people process efavirenz more slowly than others. This is thought to be linked to a genetic variation which is common in black African people. It can increase the risk of side-effects.

Sometimes, taking other medications or drugs, including over-the-counter, herbal or recreational drugs, at the same time as anti-HIV drugs can increase the chances of having side-effects.

And how you live your life might also affect your risk of some other side-effects. Some anti-HIV drugs, for example, can cause increases in blood fats, and this could be made worse if you eat lots of high-fat foods. There is some concern that treatment with some anti-HIV drugs might increase the risk of cardiovascular disease, and this can be a real concern for people with other risk factors for heart disease such as smoking or a family history of heart disease.

Other HIV drugs have been linked with liver problems, and these can also be caused by drinking too much alcohol or using recreational drugs. Being infected with hepatitis B or hepatitis C can also mean that you have an increased risk of developing liver problems if you are taking certain anti-HIV drugs.

There are actions, many of which have other health benefits as well, that you can take to reduce the risk of developing certain side-effects. These include eating a balanced diet with lots of fresh fruit and vegetables and not too much fat, taking exercise, not smoking, and not drinking too much alcohol.

If you have risk factors for side-effects (for example, a family history of heart disease or infection with hepatitis B or C), it is important that your doctor knows about them. This will enable you and your doctor to find the most suitable anti-HIV drugs for you. NAM’s online tool, Talking points (, can help you prepare for this discussion with your doctor by taking you through the health and lifestyle factors that might affect your choice of anti-HIV drugs.


Published July 2013

Last reviewed July 2013

Next review July 2016

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap