Since the advent of the human immunodeficiency virus, or HIV, in the early 1980s, the development of antivirals for treatment has produced some very effective drugs. Antivirals have given hope to many with this chronic disease and have extended the lives of infected patients. Antivirals are powerful medications that provide many benefits though they carry a risk of side effects as well.
Lactic Acidosis
According to HIV InSite, a University of Southern California-based website, nucleoside reverse transcriptase inhibitors are associated with lactic acidosis. Lactic acidosis refers to the build up of lactate in the body and the subsequent decrease of the pH of the body. The cell mitochondria produce energy for the body and this energy results in a byproduct called lactate. Usually the cell processes the lactate and eliminates it from the body. But nucleoside reverse transcriptase inhibitors are known to damage the cells and thus the lactate builds up in the body. Lactic acidosis can cause abdominal pain, nausea, vomiting, muscle pain and weakness. Without intervention lactic acidosis can cause death.
Bone Marrow Suppression
According to MayoClinic.com, a major side effect of zidovudine or AZT is bone marrow suppression. Bone marrow suppression causes a lack of red blood cells, white blood cells and platelets. A decrease in red blood cells will cause anemia which in turn can cause patients to fatigued as there is not enough blood to transport oxygen. Deficiency in white blood cells can cause a patient to be susceptible to infections or in the case of HIV, susceptibility to opportunistic infections. Insufficient platelets subject the patient to the potential for hemorrhaging as platelets are the cells that clot when bleeding occurs.
Gastrointestinal Upset
Many of the antivirals cause gastrointestinal side effects. Nausea, vomiting, abdominal pain, cramping and diarrhea are associated with protease inhibitors. Protease inhibitors affect an enzyme in the liver that is responsible for metabolizing a large number of drugs. Interference with this enzyme can create drug-drug interactions that also cause nausea and vomiting.
Lipodystrophy
According to HIV InSite, 30 to 50 percent of patients taking antivirals will have abnormalities of fat distribution. Patients taking antiviral drugs have peripheral fat loss or loss of fat in their extremities but seem to gain fat centrally. An increase in abdominal fat secondary to an increase in fat around the organs is predominant. Fat re-distribution also occurs in the upper back causing a buffalo hump and patients also complain about breast enlargement. The exact mechanism is not thoroughly understood.
References
- HIVInsite: Adverse Effects of Antiretrovirals
- "The Washington Manual of Surgery"; Marin H. Kollef, MD and et al Editors. 2008
- MayoClinic.com: HIV/AIDS - Treatments
- University of Southern California.edu: HIVInSite -- HIV Associated Lipodystrophy
