HIV Treatment Side Effects

Modern HIV medications have fewer side effects than older drugs. Learn what to expect and how to manage them.

Key Points

Modern HIV medications have far fewer side effects than older drugs.
Most side effects are mild and improve within a few weeks of starting treatment.
Never stop taking HIV medication without talking to your provider first.
Some side effects can be managed by switching to a different medication.

Common Short-Term Side Effects

When starting HIV treatment (ART), some people experience short-term side effects as the body adjusts to the medication. These typically improve within 2–4 weeks. NIH AIDSinfo notes that common short-term side effects include:

Nausea

Fatigue

Headache

Diarrhea

Vomiting

Difficulty sleeping

Dizziness

Skin rash

Long-Term Side Effects to Monitor

Kidney Problems

Associated DrugsTenofovir (TDF)

MonitoringRegular kidney function tests (creatinine, eGFR)

ManagementSwitch to TAF formulation if kidney function declines

Bone Density Loss

Associated DrugsTenofovir (TDF)

MonitoringDEXA scan every 1–2 years for at-risk patients

ManagementCalcium and vitamin D supplementation; weight-bearing exercise

Cardiovascular Risk

Associated DrugsSome older protease inhibitors

MonitoringLipid panel, blood pressure monitoring

ManagementLifestyle changes; statins if needed; consider regimen switch

Neuropsychiatric Effects

Associated DrugsEfavirenz (EFV)

MonitoringMental health screening at each visit

ManagementSwitch to integrase inhibitor-based regimen

Weight Gain

Associated DrugsIntegrase inhibitors (especially dolutegravir, bictegravir)

MonitoringWeight and BMI at each visit

ManagementDiet and exercise counseling; consider regimen modification

When to Contact Your Healthcare Provider

Contact your healthcare provider immediately if you experience any of the following serious symptoms:

⚠️Severe rash, especially with fever, blistering, or peeling skin (possible Stevens-Johnson syndrome)
⚠️Yellowing of the skin or eyes (jaundice) — possible liver toxicity
⚠️Severe abdominal pain, nausea, or vomiting — possible lactic acidosis
⚠️Muscle weakness or pain — possible myopathy
⚠️Severe depression, suicidal thoughts, or psychosis
⚠️Difficulty breathing or chest pain

For comprehensive information on HIV drug side effects, visit NIH AIDSinfo Drug Database or consult your healthcare provider.

Common Short-Term Side Effects

Nausea

Fatigue

Headache

Diarrhea

Vomiting

Difficulty sleeping

Dizziness

Skin rash

Long-Term Side Effects to Monitor

Kidney Problems

Associated DrugsTenofovir (TDF)

MonitoringRegular kidney function tests (creatinine, eGFR)

ManagementSwitch to TAF formulation if kidney function declines

Bone Density Loss

Associated DrugsTenofovir (TDF)

MonitoringDEXA scan every 1–2 years for at-risk patients

ManagementCalcium and vitamin D supplementation; weight-bearing exercise

Cardiovascular Risk

Associated DrugsSome older protease inhibitors

MonitoringLipid panel, blood pressure monitoring

ManagementLifestyle changes; statins if needed; consider regimen switch

Neuropsychiatric Effects

Associated DrugsEfavirenz (EFV)

MonitoringMental health screening at each visit

ManagementSwitch to integrase inhibitor-based regimen

Weight Gain

Associated DrugsIntegrase inhibitors (especially dolutegravir, bictegravir)

MonitoringWeight and BMI at each visit

ManagementDiet and exercise counseling; consider regimen modification

When to Contact Your Healthcare Provider

Contact your healthcare provider immediately if you experience any of the following serious symptoms:

⚠️Severe rash, especially with fever, blistering, or peeling skin (possible Stevens-Johnson syndrome)

⚠️Yellowing of the skin or eyes (jaundice) — possible liver toxicity

⚠️Severe abdominal pain, nausea, or vomiting — possible lactic acidosis

⚠️Muscle weakness or pain — possible myopathy

⚠️Severe depression, suicidal thoughts, or psychosis

⚠️Difficulty breathing or chest pain

For comprehensive information on HIV drug side effects, visit NIH AIDSinfo Drug Database or consult your healthcare provider.