HIV 101: Common Toxicities Among ARVs

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HIV Treatment in the Developing World

Brown Medical School

June 2003

Agent	Possible Class Toxicities	Additional Toxicities
NRTI
Abacavir (ABC, Ziagen)	Mitochondrial toxicity (pancreatitis, peripheral neuropathy, lactic acidosis) and lipodystrophy	Hypersensitivity reaction
Didanosine (ddI, Videx)	Mitochondrial toxicity (pancreatitis, peripheral neuropathy, lactic acidosis) and lipodystrophy	Pancreatitis, peripheral neuropathy
Lamivudine (3TC, Epivir)	Mitochondrial toxicity (pancreatitis, peripheral neuropathy, lactic acidosis) and lipodystrophy	Pancreatitis
Stavudine (d4T, Zerit)	Mitochondrial toxicity (pancreatitis, peripheral neuropathy, lactic acidosis) and lipodystrophy	Peripheral neuropathy, pancreatitis, hepatoxicity
Zalcitabine (ddC, Hivid)	Mitochondrial toxicity (pancreatitis, peripheral neuropathy, lactic acidosis) and lipodystrophy	Pancreatitis, peripheral neuropathy, oral apthae
Zidovudine (AZT, Retrovir)	Mitochondrial toxicity (pancreatitis, peripheral neuropathy, lactic acidosis) and lipodystrophy	Anemia, leukopenia, neutropenia, myositis
NtRTI
Tenofovir (TDF, Viread)		Lactic acidosis
NNRTI
Delavirdine (DLV, Rescriptor)	Hepatotoxicity; potential to cause rash
Efavirenz (EFV, Sustiva)	Hepatotoxicity; potential to cause rash	Hyperlipidemia
Nevirapine (NVP, Viramune)	Hepatotoxicity; potential to cause rash
PI
Amprenavir (APV, Agenerase)	Hyperglycemia, hyperlipidemia, and lipodystrophy. Increased risk for osteopenia and osteoporosis.
Indinavir (IDV, Crixivan)	Hyperglycemia, hyperlipidemia, and lipodystrophy. Increased risk for osteopenia and osteoporosis.	Hepatitis
Nelfinavir (NFV, Viracept)	Hyperglycemia, hyperlipidemia, and lipodystrophy. Increased risk for osteopenia and osteoporosis.
Ritonavir (RTV, Norvir)	Hyperglycemia, hyperlipidemia, and lipodystrophy. Increased risk for osteopenia and osteoporosis.	Hepatitis
Saquinavir (SQV, Invirase, Fortovase)	Hyperglycemia, hyperlipidemia, and lipodystrophy. Increased risk for osteopenia and osteoporosis.
Lopinavir/Ritonavir (LPV/RTV, Kaletra)	Hyperglycemia, hyperlipidemia, and lipodystrophy. Increased risk for osteopenia and osteoporosis.
Adapted from Bartlett, et al. 2001-2002 Medical Management of HIV Infection; and Sande, et al. The Sanford Guide to HIV/AIDS Therapy, 2002, Eleventh Edition.

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This article was provided by Brown Medical School. It is a part of the publication HEPP Report.

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