Common adverse reactions include nausea, headache, fatigue, vomiting, diarrhea, loss of appetite, and trouble sleeping. Rare but serious side effects include hypersensitivity reaction such as rash, elevated AST and ALT, depression, anxiety, fever/chills, URI, lactic acidosis, hypertriglyceridemia, and lipodystrophy. People with liver disease should be cautious about using<unk>  because it can aggravate the condition. Signs of liver problems include nausea and vomiting, abdominal pain, dark-colored urine, yellowing of the skin, and yellowing of the whites of the eyes. The use of nucleoside drugs such as<unk>  can very rarely cause lactic acidosis. Signs of lactic acidosis include fast or irregular heartbeat, unusual muscle pain, fatigue, difficulty breathing and stomach pain with nausea and vomiting.<unk>  can also lead to immune reconstitution inflammatory syndrome, a change in body fat as well as an increased risk of heart attack. Resistance to<unk>  has developed in laboratory versions of HIV which are also resistant to other HIV-specific antiretrovirals such as lamivudine, didanosine, and zalcitabine. HIV strains that are resistant to protease inhibitors are not likely to be resistant to<unk> .<unk>  is contraindicated for use in infants under three months of age. Little is known about the effects of<unk>  overdose. Overdose victims should be taken to a hospital emergency room for treatment. Hypersensitivity syndrome Hypersensitivity to<unk>  is strongly associated with a specific allele at the human leukocyte antigen B locus namely HLA-B*5701. The mechanism for this hypersensitivity reaction is due to<unk>  binding in the antigen-binding cleft of HLA-B*57:01, allowing alternative peptides to bind, which appear as "non-self" when presented to T cells. There is an association between the prevalence of HLA-B*5701 and ancestry. The prevalence of the allele is estimated to be 3.4 to 5.8 percent on average in populations of European ancestry, 17.6 percent in Indian Americans, 3.0 percent in Hispanic Americans, and 1.2 percent in Chinese Americans. There is significant variability in the prevalence of HLA-B*5701 among African populations. In African Americans, the prevalence is estimated to be 1.0 percent on average, 0 percent in the Yoruba from Nigeria, 3.3 percent in the Luhya from Kenya, and 13.6 percent in the Masai from Kenya, although the average values are derived from highly variable frequencies within sample groups. Common symptoms of<unk>  hypersensitivity syndrome include fever, malaise, nausea, and diarrhea. Some patients may also develop a skin rash. Symptoms of AHS typically manifest within six weeks of treatment using<unk> , although they may be confused with symptoms of HIV, immune reconstitution syndrome, hypersensitivity syndromes associated with other drugs, or infection. The U.S. Food and Drug Administration (FDA) released an alert concerning<unk>  and<unk> -containing medications on 24 July 2008, and the FDA-approved drug label for<unk>  recommends pre-therapy screening for the HLA-B*5701 allele and the use of alternative therapy in subjects with this allele. Additionally, both the Clinical Pharmacogenetics Implementation Consortium and the Dutch Pharmacogenetics Working Group recommend use of an alternative therapy in individuals with the HLA-B*5701 allele. Patch test Skin-patch testing may also be used to determine whether an individual will experience a hypersensitivity reaction to<unk> , although some patients susceptible to developing AHS may not react to the patch test. The development of suspected hypersensitivity reactions to<unk>  requires immediate and permanent discontinuation of<unk>  therapy in all patients, including patients who do not possess the HLA-B*5701 allele. On 1 March 2011, the FDA informed the public about an ongoing safety review of<unk>  and a possible increased risk of heart attack associated with the drug. A meta-analysis of 26 studies conducted by the FDA, however, did not find any association between<unk>  use and heart attack Immunopathogenesis The mechanism underlying<unk>  hypersensitivity syndrome is related to the change in the HLA-B*5701 protein product.<unk>  binds with high specificity to the HLA-B*5701 protein, changing the shape and chemistry of the antigen-binding cleft. This results in a change in immunological tolerance and the subsequent activation of<unk> -specific cytotoxic T cells, which produce a systemic reaction known as<unk>  hypersensitivity syndrome.
Abacavir
Fosamprenavir
Saquinavir
Coronavir
Entecavir
Fostemsavir
Indinavir
Tipranavir