Management of the adverse effects of antiretroviral therapy and medicationadherence

A commonly cited cause of poor adherence to highly active antiretroviral th erapy (HAART) is adverse drug reactions. Short-term adverse effects are pot ential threats to successful introduction and maintenance of HAART. The lon g-term toxicities of HAART are still emerging and being defined, as evidenc ed by the recently described metabolic disorders (i.e., the syndrome of mal distribution, hyperlipemia, glucose intolerance and insulin resistance). Wi th 14 licensed agents in 2000, other agents in common use, and numerous com binations of greater than or equal to 3 drugs, awareness and recognition of adverse effects are increasingly important for clinicians and patients. Th e common adverse drug reactions encountered with HAART, including new agent s and their impact on patient adherence, are reviewed. Current strategies t o anticipate and mitigate adverse effects are summarized.