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Side effects

As with all medication, starting to take treatment for HIV can cause side effects for some people.  

They are often at their worst in the first few weeks of treatment. These should usually subside over time.  

If you are struggling with side effects, tell a medical professional. They can give you other medicines to control the side effects. Or, they might change your antiretroviral drugs to others that are more manageable. 

Does antiretroviral treatment have side effects?

Many people get some side effects. This is most common in the first few days and weeks of starting treatment.  

They are unpleasant and occur because your body is getting used to the drugs. Most side effects should improve and go away altogether as your body gets used to it.  

What kind of side effects can HIV treatment cause?

There are some common side effects that are usually short-term, such as: 

  • feeling sick  

  • feeling tired 

  • having a headache 

  • having diarrhoea 

  • having a rash. 

Other side effects are long-term, including: 

  • bone, liver and kidney problems 

  • heart disease 

  • metabolic changes. 

Some side effects may be less obvious to you. For example, the commonly used drug TDF (tenofovir) can cause problems with the kidneys. Your healthcare professional will check a sample of your urine (pee) for signs of kidney problems. 

Will side effects go away?

Most people’s side effects go away within a few weeks of starting treatment. 

If yours are not going away, the best thing you can do is talk to a medical professional about it. They can tell you what to do and may prescribe something for you to take for a short period, such as an anti-nausea drug. Tell them about any other medications you are taking in case there is an interaction between the drugs you take. 

I can’t cope with these side effects. What can I do?

You must keep taking your treatment until you’ve spoken to a medical professional. This is because, if you stop, it risks HIV becoming resistant to the drugs which could mean the drugs don’t work for you anymore. 

If a side effect doesn’t go away and is affecting your quality of life, your healthcare provider may recommend that you switch drugs. 

Let's talk about side effects!

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What is first-line / second-line / third-line treatment?

First-line treatment is the first combination of antiretroviral drugs that you are given. If these drugs are causing side effects, you may be offered second-line treatment. This is a different combination of drugs. If this regimen also causes side effects, you may be offered third-line treatment. 

Tips on coping with side effects 

If you are experiencing side effects:

  • be honest with your healthcare provider – they will be able to help you 

  • ask if other medication is available to treat the side effects 

  • never stop taking your treatment before talking to your healthcare provider 

  • if side effects disrupt your sleep, try taking your treatment in the morning 

  • if your side effects affect you when you are awake, try taking your treatment before bed 

  • look after your general health by eating well, sleeping enough, and exercising. 

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  • Last updated: 31 March 2022
  • Last full review: 01 March 2022
  • Next full review: 01 March 2025
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