Side effect: hypertension/ high blood pressure
PEOPLE LIVING WITH HIV MAY EXPERIENCE MEDICATION SIDE EFFECTS — AND COMORBIDITIES, THE SIMULTANEOUS PRESENCE OF AT LEAST TWO DISEASES. HERE’S WHAT THE MOST COMMON ARE AND HOW TO TREAT THEM. BY DIANE ANDERSON-MINSHALL Side effect: diarrhea
how common: Extremely; in fact, diarrhea is among the most common reasons why people with HIV stop or switch their HIV meds. treatment: Three options: over-the-counter anti-diarrheal medicines such as Imodium (loperamide); Lomotil (diphenoxylate and atropine), which slows the gut to combat diarrhea and is commonly given to cancer patients; or Mytesi (crofelemer), the only Food and Drug Administration-approved drug to relieve noninfectious diarrhea in HIV-positive people. Derived from the red sap of the Croton lechleri plant, Mytesi is only the second botanical prescription drug approved by the FDA.
Side effect: mood changes, including depression and anxiety
how common: According to a 2019 study published in International Journal of Environmental Research and Public Health, 39 percent of people living with HIV were currently experiencing depression. AIDS Beacon previously reported that 63 percent of HIVpositive participants “reported symptoms of depression currently or at some point in the past. Overall, 26 percent of patients reported having had thoughts of suicide and 13 percent of participants reported having attempted suicide in their lifetimes.” treatment options: Selective serotonin reuptake inhibitors (SSRIs) are most effective. According to the National Institutes of Health, medications that have shown efficacy in treating depression in patients with HIV include (generic names) imipramine, desipramine, nortriptyline, amitriptyline, fluoxetine, sertraline, paroxetine, citalopram, escitalopram, fluvoxamine, venlafaxine, nefazodone, trazodone, bupropion, and mirtazapine. 40
Comorbidity: osteoporosis and osteopenia
how common: Osteopenia and osteoporosis are both forms of bone density loss, with the latter being more severe. Far more people with HIV have osteopenia (60 percent) versus osteoporosis (10-15 percent). The lower your body weight, the more susceptible you are to both. Fracture injuries are more common in young poz people because of it. treatment: Bisphosphonate therapy with vitamin D and calcium supplementation and medications including Fosamax, Boniva, Actonel, Atelvia, and Reclast. And just this year, a study presented at the virtual Conference on Retroviruses and Opportunistic Infections indicated that a “short course of alendronate” (the generic term for Fosamax and Binosto) at the beginning of tenofovir-based antiretroviral therapy can help prevent bone loss.
Comorbidity: cardiovascular disease
how common: It’s the second leading cause of death among people living with HIV. treatment: It may include a variety of approaches. There are cholesterol-lowering statin drugs such as Crestor, Lipitor, Zocor, Vytorin, Lescol, Mevacor, Altoprev, Livalo, Pravachol, Advicor, and Simlup. Programs that help you stop smoking, shed excess pounds, and exercise more are all useful. Reduce alcohol and sodium consumption. If your blood pressure is not in a healthy range, your doctor may prescribe medication. Among the options are ACE inhibitors (Vasotec, Prinivil, Zestril, Altace); angiotensin II receptor blockers (Cozaar, Atacand, Diovan); beta blockers (Lopressor, Toprol XL, Corgard, Tenormin); or calcium channel blockers (Norvasc, Cardizem, Dilacor XR, Adalat CC, Procardia).
Comorbidity: diabetes
how common: There’s a type of diabetes caused by pancreatic damage brought on by HIV medications. It’s less common than the other two types, Type 1 and Type 2, but equally damaging. treatment: Controlling blood sugar, medication, insulin treatment, and proper diet are the main treatments, with regular doctor screenings for easy-to-miss complications. Diabetes meds include Lantus, Januvia, Humalog, NovoRapid, Victoza, Farxiga, and about a dozen more.
SHUTTERSTOCK
KNOW YOUR SIDE EFFECTS AND COMORBIDITIES
how common: Very. The U.S. Department of Veterans Affairs, for example, reports that 45 percent of its patients with HIV also have a hypertension diagnosis. A report from last year found that a quarter of all people with HIV also have hypertension, with the comorbidity most prevalent in North America and Western Europe. A 2018 review of findings, published in Hypertension, suggests that chronic inflammation associated with HIV and antiretroviral therapy is a major factor in the high rates of hypertension. treatment: Stop smoking. Medications include vasodilators (hydralazine), antihypertensives (Cozaar, Avapro, Diovan), ACE inhibitors (Prinivil, Lotensin), calcium channel blockers (Norvasc, Procardia, Plendil), and diuretics (Microzide, Diuril, Zestoretic).
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