HIV: How to cope with side effects of antiretroviral medicines
Shortly after Musa began taking his antiretroviral medicines, he noticed that he always felt like scratching his body. He had just overcome his shock of the diagnosis that he was positive and at first wondered whether it was the HIV in his system that was causing the itching or the medicines.
Later he realized that it happened whenever he took the drugs.
Like Musa, Madam Ebun, 40, noticed that she always felt like vomiting whenever she took her drugs daily.
While antiretroviral medicines are one of the best things to have happened in the HIV treatment journey, as it stopped people from dying from AIDS as those infected did decades ago, it does have side effects like all other drugs.
According Pharmacist Avong Yohanna, head of pharmacy at the Institute of Human Virology, Nigeria (IHVN), antiretroviral (ARV) are medications taken to suppress the HIV virus in the body so that it does not progress to AIDS and create other health conditions that will eventually kill the patient.
The pharmacist, who has published several studies on the adverse effects of medicines, said there are many antiretroviral medicines and each has its side effects. He added that side effects of antiretroviral can be broadly categorized into two.
The first are side effects that are very serious and could lead to death and mainly caused by two drugs, while the second ones are common and could be managed with drugs .
“The first type are side effects that you cannot control, because they cannot be tolerated by the patient and the medication has to be stopped otherwise, it may lead to the patient’s death while the second type can be tolerated by the patient. In other words, the patient can manage and control it,” said Pharmacist Yohanna.
He said the first category of side effects is caused by two drugs: Nevirapine which causes Steven Johnson Syndrome, and Abacavir which causes high sensitivity reaction (HSR).
The side effect of Nevirapine which causes Steven Johnson Syndrome make the person to appear as if hot water was poured on him or her; the patient burns seriously in most cases, and if there is no expert to manage the person, it can lead to his death, he said. The expert said the drug is stopped and removed from the patient’s treatment if such side effect occurs.
The other drug, Abacavir causes high sensitivity reaction (HSR) that is dangerous and could be fatal.
Pharmacist Yohanna said some antiretroviral medicines could also affect the structure of a person’s body. That is, a man for instance may develop breasts like a woman, and in such a form that people may think the person is a woman. He added that such side effects usually disappear with time, once the person stops the drugs.
The expert said drugs and precaution could be used to control the other category of side effects, which are not as serious as the first. Examples include vomiting or nausea, itching and scratching, loss of appetite, and loss of sleep among others.
He said whenever people feel any side effect or symptom they should report it to their doctor or healthcare provider immediately, who then examines them and prescribes the appropriate treatment.
“This is important because sometimes, the side effect will look ordinary from the beginning but it can become very terrible later,” he advised.
He said aside drugs for managing vomiting and nausea in patients that experience such side effects, medical experts also advice precautions such as not eating oily or peppery food because they could lead to other problems when the person starts vomiting.
He said medications like ointment to rub on the skin could be prescribed to relieve side effects of itching. Others include advising people to take the drugs that cause sleep at night and the ones that don’t cause sleep in the morning or during the day.
Asked if antiretroviral reacts with drugs for other diseases such as tuberculosis, hepatitis or cancer for those who have them in addition to HIV, he said drug interactions could occur when drugs are taken along with other drugs and some may be harmful.
However, he said there are three approaches to handling the situation. Firstly, it is either the treatment of one of the diseases is finished before commencing the other, or both are conveniently treated but the patient does not take all the set of drugs at the same time.
“For example, you can treat TB and make sure the TB is completely cured before you start using the ARV. It is possible to treat HIV with antiretroviral drugs, and drugs for other diseases at the same time without problem. But you will make sure that the medication is not taken at the same time, may be you take one set of medication in the morning, then the other set in the night. That is the general principle that we use,” he explained.
The expert said overall, antiretroviral drugs are good except for the two drugs which could cause Stephen Johnson Syndrome and Abacavir reaction and require close attention so that patients with side effects will discontinue their usage.
Pharmacist Yohanna, who has also published studies on accessing HIV care in community pharmacies, added that people should not be shy or ashamed to go for diagnosis and when positive commence treatment.