Clinical Overview of HIV Disease

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Table 4: Selected adverse reactions associated with antiretrovirals

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs, 'nucs')
Class effects: Lactic acidosis +/- hepatic steatosis (most common with d4T, ddI, and AZT)

Abacavir ( Ziagen , ABC) - Hypersensitivity, fever, rash, GI symptoms, dyspnea
Combivir (Zidovudine + Lamivudine, CBV) - See AZT + 3TC
Didanosine ( Videx , ddI) - Pancreatitis, peripheral neuropathy, GI symptoms
Emtracitabine ( Emtriva , FTC) - Minimal
Lamivudine ( Epivir , 3TC) - Minimal
Stavudine ( Zerit , d4T) - Peripheral neuropathy, pancreatitis, lipoatrophy, ascending paresis (rare)
Tenofovir ( Viread , TDF) - Minimal; renal toxicity (rare)
Trizivir (Zidovudine + Lamivudine + Abacavir, TZV) - See AZT + 3TC + ABC
Zalcitabine ( Hivid , ddC) - Peripheral neuropathy, stomatitis
Zidovudine ( Retrovir , AZT, ZDV) - Anemia, neutropenia, headache, asthenia, GI symptoms (nausea)

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Delavirdine ( Rescriptor , DLV) - Rash, hepatitis
Efavirenz ( Sustiva , EFV) - CNS symptoms, sleep disturbance, rash
Nevirapine ( Viramune , NVP) - Rash, hepatitis, hepatic necrosis

Protease Inhibitors (PIs)
Class effects: Lipodystrophy, hyperlipidemia (except ATV)

Amprenavir ( Agenerase , APV) - GI symptoms, rash, oral paresthesias
Atazanavir ( Reyataz , ATV) - Hyperbilirubinemia, GI symptoms, prolonged QT interval on EKG
Fosamprenavir ( Lexiva , FPV) - Rash, GI intolerance, headache
Indinavir ( Crixivan , IDV) - GI symptoms, nephrolithiasis, hyperbilirubinemia
Lopinavir/ritonavir ( Kaletra , LPV/r) - GI symptoms (diarrhea), asthenia
Nelfinavir ( Viracept , NFV) - Diarrhea
Ritonavir ( Norvir , RTV) - GI symptoms, paresthesia, hepatitis
Saquinavir ( Fortovase , Inverase , SQV) - GI symptoms

Fusion Inhibitors

Enfuvirtide ( Fuzeon , T-20) - Injection site reactions (painful nodules)

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C. Bradley Hare, MD, University of California San Francisco
January 2006
From the HIV InSite Knowledge Base