Although these side effects can sound very scary, the important point is that they can usually be avoided with proper care and monitoring. If you need help finding a care provider that's experienced in treating HIV, call The Network. The next issue of Treatment Review will have a full update on the body shape changes and face wasting (sometimes called lipodystrophy) that are also side effects of HAART. Anti-HIV drugs can cause serious side effects. Because HAART combinations include three or more anti-HIV drugs, watching out for side effects is becoming even more important. Laboratory testing (bloodwork) is one of the methods used to monitor for potential side effects. In addition to regular bloodwork, if you're taking HAART combinations you should talk to your doctor about: Triglycerides and cholesterol: These are types of fats found in the blood. HAART combinations, especially combinations including protease inhibitors, have been linked to increases in these fat levels. Fat build up in blood vessels can cause heart disease. Heart problems, including heart attacks, have been reported in a few people taking HAART combinations in the United States and United Kingdom. General recommendations about cholesterol levels and heart disease say that a level of less than 200 mg/dL is best, while 200 - 239 may be a little high. Cholesterol levels of 240 or greater are associated with a high risk of heart disease. The normal range for triglycerides is 40 - 150 mg/dL. HIV infection alone can sometimes cause triglycerides to be higher than normal.

Blood sugar: High blood sugar is another potential side effect of HAART. In some cases, high blood sugar has led to diabetes. As with fat levels, this problem has most often been linked to protease inhibitors. Blood sugar levels can be monitored to look for any sign of this problem. Some doctors recommend using a test called the glucose tolerance test (GTT), which also looks for signs of diabetes.

Kidney function: Several anti-HIV drugs can potentially cause kidney damage. If signs of kidney damage are not noticed quickly enough, the kidneys can fail. Kidney failure is life-threatening. The protease inhibitor Crixivan can cause kidney stones. These aren't always normal kidney stones, but solid lumps of Crixivan that have formed in the kidneys. Early Crixivan studies found that about 1 in 20 (5%) of people taking the drug got kidney stones. A recent study in women found that about 1 in 4 (28%) developed signs of kidney problems after a year. In a few cases, these kidney stones have led to kidney failure. Kidney problems have also been reported with the protease inhibitor ritonavir (Norvir). The experimental anti-HIV drug adefovir (Preveon) can cause a type of kidney damage called Fanconi-like syndrome. In some cases, Preveon-related kidney damage has not improved despite stopping the drug. Monitoring kidney function includes measuring creatinine levels in the blood and regular testing of the urine for signs of kidney problems.

Uric acid: Testing blood levels of uric acid can monitor for a condition called hyperuricemia. This condition can also be a sign of kidney problems. Symptoms of hyperuricemia are joint pain and arthritis. Several studies have reported these problems in people taking HAART.

Liver function: Liver problems are a common side effect of many prescription drugs. The basic tests for measuring the health of the liver are called liver enzyme tests. These are usually done as a part of regular bloodwork. NRTI anti-HIV drugs (AZT, ddI, ddC, d4T, 3TC, abacavir) can - very rarely - cause a severe and potentially life-threatening liver problem called lactic acidosis. Symptoms of lactic acidosis are severe nausea, vomiting and rapid breathing. A blood measurement called serum bicarbonate can also be used to help diagnose this problem. Serum bicarbonate levels often drop below normal levels as a result of lactic acidosis. If this problem occurs it requires stopping and replacing the offending NRTI drug.

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