Antiretroviral therapy is associated with a variety of side-effects, ranging from mild nausea, to persistent fatigue, to life-threatening liver toxicity. Fortunately, many of the most common symptoms are worse when HIV-positive people start taking a new drug, before resolving spontaneously after the body adjusts to the medication. For this reason, it is important not to stop taking a drug too soon.

If symptoms do not improve within several weeks or are unacceptably interfering with daily activities, however, drugs may have to be discontinued. In one study, about one-quarter of treatment-naive patients who changed or discontinued drugs during the first year did so because of side-effects^[1]. Such changes should not be made without medical advice. In some cases, dose reduction may be possible, but this can lead to loss of HIV viral suppression and the development of drug resistance.

While side-effects such as nausea and fatigue are quite common, many people taking antiretroviral therapy experience few or no symptoms, while some symptoms may be due to HIV infection itself rather than its treatment. In one study of more than 1600 women, symptoms attributed to antiretroviral therapy such as nausea, loss of appetite, fatigue, fever, headaches, dizziness, rash, and muscle pain were about as common amongst untreated HIV-positive women as those taking antiretroviral therapy. In addition, the patients who changed drugs experienced more symptoms than those who stayed on a stable regimen^[2].