Page 174 - HIV/AIDS Guidelines

Table 13. Antiretroviral Therapy-Associated Common and/or Severe Adverse Effects

(See Appendix B for additional information listed by drug.) (Page 1 of 4)

Adverse Effects NRTIs NNRTIs PIs INSTI EI

Bleeding events All PIs: ↑ spontaneous bleeding, hematuria in
patients with hemophilia

TPV: Reports of intracranial hemorrhage. Risks
include CNS lesions, trauma, surgery,
hypertension, alcohol abuse, coagulopathy, and
concomitant use of anti-coagulant or anti-platelet
agents including vitamin E

Bone marrow ZDV: Anemia, neutropenia
suppression

Cardiovascular ABC and ddI: Associated with MI in some PIs: Associated with MI and stroke in some cohort
disease (CVD) but not all cohort studies. Absolute risk studies. Data on newer PIs (ATV, DRV, and TPV) are
greatest among patients with traditional limited.
CVD risk factors.
SQV/r, ATV/r, and LPV/r: PR interval prolongation.
Risks include structural heart disease, conduction
system abnormalities, cardiomyopathy, ischemic
heart disease, and coadministration with drugs that
prolong PR interval.

SQV/r: QT interval prolongation in a healthy
volunteer study. Risks include underlying heart
conditions, pre-existing prolonged QT or
arrhythmia, or use with other QT-prolonging drugs.
ECG prior to SQV initiation is recommended and
should be considered during therapy.

Central nervous d4T: Associated with rapidly progressive EFV: Somnolence, insomnia, abnormal
system (CNS) effects ascending neuromuscular weakness dreams, dizziness, impaired
resembling Guillain-Barré syndrome (rare) concentration, depression, psychosis,
suicidal ideation. Symptoms usually
subside or diminish after 2–4 weeks.
Bedtime dosing may reduce symptoms.
Risks include history of psychiatric
illness, concomitant use of agents with
neuropsychiatric effects, and increased
plasma EFV concentrations due to genetic
factors or increased absorption with food.

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents K-8
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