Table 21. Common and/or Severe Adverse Effects Associated with Antiretroviral Medications

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This table focuses on antiretroviral (ARV)-associated adverse effects that a person may experience as a result of taking an ARV regimen. The attribution of adverse effects to individual ARVs is inherently limited by the absence of long-term monotherapy trials, making it difficult to delineate the specific contribution of each medication within the combination regimens. These limitations should be considered carefully when assessing causality, as adverse effects may be related to the ARV regimen as a whole rather than to any single component.

Adverse effects for ARV medications that are no longer on the market or are not commonly used in clinical practice (didanosine [ddI], fosamprenavir/ritonavir, indinavir, lopinavir/ritonavir, nelfinavir, nevirapine, saquinavir/ritonavir, stavudine [d4T], tipranavir/ritonavir, zidovudine [ZDV]), with few exceptions, have been removed from this table. Clinicians should refer to the product labels or to the archived July 10, 2019, version of the Guidelines for information regarding the adverse effects associated with select older ARVs. Because some adverse effects may persist long after discontinuation of the older ARVs—such as d4T, ddI, zalcitabine, and ZDV—and people with HIV may still present with these long-lasting toxicities, these medications remain listed among the ARVs associated with adverse effects such as lipodystrophy and peripheral neuropathy.

For information regarding potential adverse effects of ARVs on fetuses and newborns when certain ARVs are taken around the time of conception or during pregnancy, refer to the Perinatal Guidelines.

This table highlights the common and/or severe adverse effects by ARV class and for individual ARVs, when appropriate. For ARV class–specific adverse effects, the table provides relative comparisons among individual ARVs for each class effect. In some cases, the terms “no known effect,” “rarely observed” (for select severe effects), “not common or severe,” or “no or limited data” are used, especially for the entry inhibitor and capsid inhibitor classes, where the evaluation of safety is based mostly on uncontrolled and nonrandomized clinical trials. See Appendix A, Tables 3, 4, 5, 6, 7, 8, 9, and 10 for additional information listed by ARV medication.

Table 21. Common and/or Severe Adverse Effects Associated With Antiretroviral Medications

Adverse Effect Type

Adverse Effect

NRTIs

NNRTIs

PIsINSTIsEIsCI
Cardiovascular EffectsCardiac Conduction EffectsNo known effects

RPV and EFV: QTc prolongation

RPV: QTc prolongation occurred at 3 and 12 times the recommended dose. Consider alternatives when coadministered with drugs with known risk of Torsade de Pointes.

ATV: PR prolongation. Risk factors include pre-existing heart disease and concomitant use of medications that may cause PR prolongation.No known effectFTR: QTc prolongation was seen at 4 times the recommended dose. Consider alternatives when coadministered with drugs with a known risk of Torsade de Pointes.No known effect
Cardiovascular DiseaseABC: Associated with an increased risk of MI in some cohort studies. Absolute risk greatest in people with traditional CVD risk factors.No known effectDRV/r: Associated with cardiovascular events in some cohorts.Not common or severeNo or limited dataNo or limited data
Dermatologic Effects, Not Including Systemic Hypersensitivity ReactionRashFTC: Skin hyperpigmentationAll NNRTIsATV, DRVAll INSTIsMVC, IBA, FTRNot common or severe
Stevens-Johnson Syndrome/Toxic Epidermal NecrosisNo known effectEFV, ETR > DOR, RPVRarely observed with DRV and ATVRarely observed with BIC, CAB, and RALNo or limited dataNot common or severe
Gastrointestinal EffectsCholelithiasisNo known effectNo or limited dataATV: Cholelithiasis and kidney stones may present concurrently. Median onset is 42 months after ARV initiation.No known effectNo known effectNo known effect
Gastrointestinal EffectsZDV > other NRTIs: Nausea and vomiting Not common or severeGI intolerance (e.g., diarrhea, nausea, vomiting)EVG/c: Nausea and diarrheaNo known effectNot common or severe
Hepatic EffectsHepatic EffectsWhen TAF, TDF, 3TC, and FTC are withdrawn in people with HBV/HIV coinfection or when HBV resistance develops: People with HBV/HIV coinfection may develop severe hepatic flares.

EFV: Most cases relate to an increase in transaminases. Fulminant hepatitis leading to death or hepatic failure requiring transplantation have been reported.

RPV: Risk may be further increased in people with HBV or HCV coinfection.

All PIs: Drug-induced hepatitis and hepatic decompensation have been reported.

ATV: Jaundice due to indirect hyperbilirubinemia

DTG: Rarely observed, but risk may be further increased in people with HBV or HCV coinfection.

BIC, CAB, EVG/c, RAL: Not common or severe

MVC: Hepatotoxicity with or without rash or HSRs has been reported.

FTR: Transaminase elevation was seen more commonly in patients with HBV/HCV. Transient elevation of bilirubin observed in clinical trials.

Not common or severe
Hypersensitivity Reactions, Not Including Rash Alone or Stevens-Johnson SyndromeHypersensitivity Reaction

ABC: Contraindicated if person is HLA-B*5701 positive.

Median onset for HSR is 9 days after treatment initiation; 90% of reactions occur within 6 weeks.

HSR symptoms (in order of descending frequency): Fever, rash, malaise, nausea, headache, myalgia, chills, diarrhea, vomiting, abdominal pain, dyspnea, arthralgia, and respiratory symptoms

Symptoms worsen with continuation of ABC.

People should not be rechallenged with ABC if HSR is suspected, regardless of their HLA-B*5701 status.

Rarely observedNo known effectRarely observed

MVC: HSR reported as part of a syndrome related to hepatotoxicity.

IBA: HSR, including infusion-related reactions and anaphylactic reactions, were reported.

No known effect
Injection Site ReactionsInjection Site ReactionNot applicable

RPV IM injection: Reported in >80% of patients; reactions may include localized pain/discomfort (most common), nodules, induration, swelling, erythema, hematoma.

When given with CAB IM, injection site pain: RPV > CAB.

Not applicable

CAB IM injection: Reported in >80% of patients; reactions may include localized pain/discomfort (most common), nodules, induration, swelling, erythema, hematoma.

When given with RPV IM, injection site pain: RPV > CAB.

 

Not applicableLEN SQ injection: Reported in 47–‍65% of people; reactions may include swelling, erythema, pain, nodules, inflammation, and induration. Nodules and induration may persist for months in some people. Injection site necrosis has been reported.
Metabolic EffectsBone Density EffectsTDF: Associated with greater loss of BMD than other NRTIs, especially when given with a PK booster. Osteomalacia may be associated with proximal tubulopathy and urine phosphate wasting.

TAF: Associated with smaller declines in BMD than those seen with TDF.
No known effectNo known effectNot common or severeNo known effectNo known effect
Diabetes Mellitus and Insulin ResistanceZDVNo known effectRarely observedNo known effectNo or limited dataNo or limited data
Dyslipidemia

ABC: ↑ TG and ↑ LDL

TAF: ↑ TG, ↑ LDL, and ↑ HDL (no change in TC:HDL ratio)

TDF: Associated with lower lipid levels than ABC or TAF.

EFV: ↑ TG, ↑ LDL, ↑ HDLAll RTV- or COBI-boosted PIs: ↑ TG, ↑ LDL, ↑ HDLEVG/c: ↑ TG, ↑ LDL, ↑ HDLNo known effectNo known effect
Lactic AcidosisReported with older NRTIs (e.g., d4T, ZDV, ddI), but not with ABC, 3TC, FTC, TAF, or TDF.No known effectNo known effectNo known effectNo known effectNo known effect
LipodystrophyLipoatrophy: Associated with history of exposure to d4T or ZDV (d4T > ZDV). Not reported with ABC, 3TC or FTC, or TAF or TDF.Lipohypertrophy: Trunk fat increase is observed with EFV-containing regimens; however, a causal relationship has not been established.Lipohypertrophy: Trunk fat increase is observed with PI-containing regimens; however, a causal relationship has not been established.Lipohypertrophy: Trunk fat increase is observed with RAL-containing regimens; however, a causal relationship has not been established.No known effectNo known effect
Weight GainWeight gain has been associated with initiation of ART and subsequent viral suppression. The increase appears to be greater with INSTIs, especially BIC and DTG, than with other drug classes. Greater weight increase has also been reported with TAF than with TDF and with DOR than with EFV.No known effectNo known effect
Musculoskeletal EffectsMyopathy/ Rhabdomyolysis

ddI, D4T

Rarely observed with ABC, TAF, or TDF.

No known effectNo known effectRarely observedNo known effectNo known effect
Neuropsychiatric EffectsNervous System/Psychiatric EffectsPeripheral neuropathy (can be irreversible): Associated with history of exposure to ddI, ddC, or d4T.

Neuropsychiatric events: EFV > DOR, RPV > ETR

EFV: Somnolence, insomnia, abnormal dreams, dizziness, impaired concentration, depression, psychosis, suicidal ideation, ataxia, encephalopathy. Some symptoms may subside or diminish after 2–4 weeks. Bedtime dosing and taking without food may reduce symptoms.

RPV: Depression, suicidality, sleep disturbances

DOR: Sleep disorders and disturbances, dizziness, altered sensorium; depression, suicidality, and self-harm

No known effectInsomnia, depression, and suicidality have been reported with INSTI use, primarily in people with pre-existing psychiatric conditions.Not common or severeNot common or severe
Renal EffectsRenal Effects/Nephrolithiasis/
Urolithiasis

TDF: ↑ SCr, proteinuria, hypophosphatemia, urinary phosphate wasting, glycosuria, hypokalemia, and non-anion gap metabolic acidosis. Concurrent use of TDF with COBI- or RTV-containing regimens appears to increase risk.

TAF: Less renal effect than TDF.

RPV: Inhibits Cr secretion without reducing renal glomerular function

ATV: Associated with increased risk of chronic kidney disease in a large cohort study.

ATV: Stone or crystal formation; adequate hydration may reduce risk

COBI (as a pharmacokinetic booster for DRV or ATV): Inhibits Cr secretion without reducing renal glomerular function

DTG, COBI (as a pharmacokinetic booster for EVG), and BIC: Inhibits Cr secretion without reducing renal glomerular functionNo or limited dataNo or limited data
Key: 3TC = lamivudine; ABC = abacavir; ART= antiretroviral therapy; ARV = antiretroviral; ATV = atazanavir; BIC = bictegravir; BMD = bone mineral density; CAB = cabotegravir; CI = capsid inhibitor; COBI = cobicistat; Cr = creatinine; CVD = cardiovascular disease; d4T = stavudine; ddC = zalcitabine; ddI = didanosine; DOR = doravirine; DRV = darunavir; DRV/r = darunavir/ritonavir; DTG = dolutegravir; EFV = efavirenz; EI = entry inhibitor; ETR = etravirine; EVG = elvitegravir; EVG/c = elvitegravir/cobicistat; FTC = emtricitabine; FTR = fostemsavir; GI = gastrointestinal; HBV = hepatitis B virus; HCV = hepatitis C virus; HDL = high-density lipoprotein; HSR = hypersensitivity reaction; IBA = ibalizumab; IDV = indinavir; IM = intramuscular; INSTI = integrase strand transfer inhibitor; LDL = low-density lipoprotein; LEN = lenacapavir; MI = myocardial infarction; MVC = maraviroc; NNRTI = non-nucleoside reverse transcriptase inhibitor; NRTI = nucleoside reverse transcriptase inhibitor; PI = protease inhibitor; QTc = QT corrected for heart rate; RAL = raltegravir; RPV = rilpivirine; RTV = ritonavir; SCr = serum creatinine; SQ = subcutaneous; TAF = tenofovir alafenamide; TC = total cholesterol; TDF = tenofovir disoproxil fumarate; TG = triglycerides; ZDV = zidovudine