These drugs, however, are associated with side effects and long-term complications with which HIV clinicians must familiarize themselves so that they can anticipate harmful consequences and intervene effectively if they occur. PIs are usually used in combination with other drugs, a practice that also contributes to the frequency of adverse events. Use of combination regimens can make it difficult to determine with certainty which drug is the causative agent.
Individuals differ in terms of which side effects they consider most tolerable.
There are few data indicating whether an individual patient is likely to develop a specific side effect. When a regimen has been selected, it is important to stress to the patient that its efficacy depends on adhering closely to the regimen as prescribed and reporting troublesome side effects to the clinician so alternatives can be discussed. Ohmit et al reported at the 12th World AIDS Conference Geneva that side effects are the second leading cause of nonadherence. The patient should be instructed never to discontinue only one or two drugs in a regimen, because doing so will foster the development of resistance and result in virologic failure. If a side effect is intolerable and the clinician cannot be contacted, the patient should stop all drugs at once.