Adverse Drug Effects

Differentiating between complicating consequences of HIV infection and toxicities of drugs used in the management of HIV infection is challenging. However, the experience gained with combination antiretroviral (ARV) drugs has led to the recognition of several distinct adverse drug events. These include: • mitochondrial dysfunction (including lactic acidosis, hepatic toxicity, pancreatitis, and peripheral neuropathy); • metabolic abnormalities (such as fat maldistribution and body habitus changes; hyperlipidemia; hyperglycemia and insulin resistance; and osteopenia, osteoporosis, and osteonecrosis); • hematologic adverse events from drug-induced bone marrow suppression (anemia, neutropenia, and thrombocytopenia); and • allergic reactions (skin rashes and hypersensitivity responses).