The same treatments against HIV that have reduced mortality and the development of diseases associated with AIDS can cause adverse effects that, if not treated properly, negatively impact on quality of life, on therapeutic compliance and, consequently, on the control of the infection itself. Knowing these side effects and learning how to handle them are the objectives of ITVIH Program, presented in the XIV National Congress on AIDS to NGOs across the country that specialize in helping HIV positive people.

For María José Fuster, manager of the Spanish Interdisciplinary AIDS Society (SEISIDA) and coordinator of the program, although there is no doubt that the antiretroviral therapy is directly responsible for fewer deaths and associated diseases, it is also that "increasingly deterioration in the quality of life of patients occurs by pathologies derived from the adverse effects of the therapies, and not by the infection itself of HIV ". "It is important," he stresses, "to try to find solutions to maintain the best possible quality of life for those affected. In addition, some of these side effects can lead people with HIV to not take medication correctly, and even not take it. "

"Side effects can lead people with HIV not to take the medication correctly, and even not take it"

The ITVIH program, which has been designed by Bristol-Myers Squibb, provides basic information about the treatment (when to start it, when to change it, the importance of complying with it, the way in which drugs act on the virus, ...), and is aimed at train members of NGOs so that they, in turn, guide patients about tolerance, side effects, and management of complications associated with HIV treatment.

The most novel contribution of this initiative, however, lies in the strategies and tricks offered to manage side effects. "The objective has been to put in the hands of people with HIV and their environment a practical tool that helps them minimize possible complications. The councils are also elaborated from a multiple perspective, ranging from dietary strategies to psychological, through behavior changes. It has not been entered into the purely medical advice, but rather in the complementary measures that can help. For example, if the cholesterol is high, a statin (lipid-lowering medication) is not recommended, but certain low-fat foods, physical exercise, ... ", explains Fuster.

Short and long term side effects

The side effects at the beginning of the treatment differ from those that usually appear when the patient has been using it for a long time or with different treatments. At the beginning, they are more common gastrointestinal disorders (nausea, vomiting, diarrhea), neuropsychiatric disorders (sleep disorders, dizziness) or hypersensitivity reactions like skin rashes. More long-term complications may arise such as metabolic disorders, increased cardiovascular risk or lipodystrophy (redistribution of body fat). Other consequences associated with the treatment contemplated in the program are the liver and kidney toxicity, skin problems, the effect on sex or osteoporosis.

"Not always," says Fuster, "are minor problems; some may contribute to premature aging of the patient and even reduce their life expectancy. Therefore, it is necessary to continue innovating in the treatment with the development of more comfortable and safe drugs, without this supposing less antiviral efficacy, but it is also good to learn how to best manage these adverse effects. The patient's quality of life and adherence to treatment will depend on this ".

Source: Bristol-Myers Squibb

Treating HIV Immediately (November 2019).