Nursing Care for HIV - Adverse Effects for Nurses

Authors: Jantjie Taljaard, MD, DTM&H; Julia Bereda-Thakhathi, MACUR, PHC Specialist
Editors In Chief: Ian M. Sanne, MBBCH, FCP(SA); Stacie Stender, MSN, MSc ID, FNP (More Info)

Last Reviewed: July 8, 2016 (What's New)

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inPractice® Africa’s Continuing Education Unit (CEU) provider, the South African Medical Association, offers physicians 3 CPD points on a 70% pass rate for completing this individual module. Nonphysicians who successfully complete the module will receive a participation certificate. To learn more on CPD credits and participation certificates, click here.

Introduction to Adverse Effects Patients May Experience on Antiretroviral Therapy

  • Most people who receive antiretrovirals (ARVs) will experience adverse effects associated with their treatment regimen
  • This does not mean that ARVs are a particularly dangerous group of drugs
  • All drugs come with adverse effects. Examples include the following:
    • Ibuprofen has been shown to cause gastrointestinal adverse effects in 12% to 19% of patients on a 1200 mg/day dose[Bjarnason 2007]
    • Amoxicillin is also frequently associated with gastrointestinal adverse effects, as well as a risk of hypersensitivity reactions including skin rash[SAMF 2012]
    • Numerous other drugs commonly used for the treatment of HIV-related infections, such as antituberculosis treatment and cotrimoxazole, also have adverse effects similar to those of ARVs
  • The adverse-effect profile of ARVs is comparable to many other widely used medications
    • This is not to dismiss the potential for long-term complications, but many medications can cause other health issues when taken for many years
    • ARV toxicity, however, makes the patient feel ill and is a leading cause for treatment nonadherence and therefore treatment failure[Rosen 2008]
    • It is important to know the adverse effects of each ARV drug to recognize toxicity, which may occur, and change the treatment to a more suitable treatment for the patient
    • It is also important to educate each patient about adverse effects that may occur with their ARVs so that they can understand that the adverse effects may only last for a while
  • Newer ARVs are easier to tolerate than older drugs and appear to have better, or at least different, long-term safety profiles[Brennan 2012]
    • Integrase inhibitors do not share some of the negative characteristics of the older ARV
  • HIV-positive patients have a higher risk of developing reactions to all drugs. This should be kept in mind when considering an ARV-related reaction