Toxicity & side effects: switching therapy

Lisa A. Spacek, M.D., Ph.D.


  • Modification of ART regimen in virologically suppressed patients[3]
    • Reduce or prevent toxicity
      • Newer regimens are associated with fewer serious adverse effects. From 2011 to 2017, Swedish registry found that reporting of side effects decreased from 32% to 15%.[8]
      • PLWH initiating ART in trials report short-term adverse effects infrequently (< 10%).
    • Improve long-term adherence by reducing pill burden and dosing frequency OR eliminating dietary requirements[2]
    • Avoid long-term ART toxicities, especially in setting of co-morbidities, such as cardiovascular, kidney, or metabolic disease
    • Avoid drug interactions
      • For example, in solid organ transplantation, drug-drug interactions occur between protease inhibitors (i.e., DRV) or pharmacokinetic boosters (i.e., cobi) and required immunosuppressive medications (i.e., tacrolimus).[2]
    • Exercise option of long-acting injectable ART

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Last updated: October 19, 2022