Side effects of first-line ARV drugs 1- Tenofovir - TDF

The article was written by Doctor, Dr. Le Xuan Luat - Infectious, hepatobiliary doctor - Department of General Internal Medicine, Vinmec Times City International General Hospital.

The first case of HIV infection in the world was discovered in the US in 1981. The first case of HIV infection was discovered in Vietnam in 1990 in Ho Chi Minh City. As of August 2020, there are about 213,008 living HIV infections in Vietnam. Of these, more than 153,000 people living with HIV are on antiretroviral therapy (ARV).

1. First-line ARV regimen

According to Decision 5456/QD-BYT on HIV/AIDS treatment and care guidelines, issued on November 20, 2019, people who are found to be infected with HIV will be counseled and started on antiretroviral therapy. The purpose of taking ARV is to inhibit HIV replication in the body and restore immune function. The benefits of antiretroviral therapy are reduced opportunistic infections and improved quality of life for people living with HIV. It also prevents HIV transmission from one infected person to another. Zidovudine (AZT) was the first drug used to treat HIV since 1987. Since then, many HIV drugs with different mechanisms have been studied and used in patients.
1st line ARV regimens are commonly used for HIV treatment beginners as shown in the table below:
Table 1: First line ARV regimens

Đối tượng	Phác đồ ưu tiên	Phác đồ thay thế	Phác đồ đặc biệt (khi không dùng được hoặc không có phác đồ ưu tiên hay thay thế)
Người lớn bao gồm cả phụ nữ mang thai (*) và trẻ từ 10 tuổi trở lên	TDF + 3TC (hoặc FTC) + DTG1	TDF + 3TC + EFV 400 mg	TDF + 3TC (hoặc FTC) + EFV 600mg AZT + 3TC + EFV 600 mg TDF + 3TC (hoặc FTC) +PI/r ABC + 3TC + DTG1
Trẻ dưới 10 tuổi	ABC+ 3TC + DTG	ABC+3TC+ LPV/r	ABC + 3TC + EFV3 (hoặc NVP) AZT + 3TC + EFV3 (hoặc NVP) AZT + 3TC + LPV/r (hoặc RAL)
Trẻ sơ sinh (trẻ dưới 4 tuần tuổi)	AZT+3TC+RAL	AZT+3TC+NVP	AZT+3TC+LPV/r

Table 2: Symbols of ARV drug names

Tên thuốc	Viết tắt
Tenofovir	TDF
Efavirenz	EFV
Lamivudine	3TC
Abacvir	ABC
Dolutegravir	DTG
Nevirap	NVP
Lopinavir/ ritonavir	LPV/r
Raltegravir	RAL

Patients taking the drug should adhere to the medication regimen and visit the doctor periodically as directed by the treating physician. The treating doctor will assess the patient's condition and decide which regimen to use, changing the drug regimen when necessary. Drug side effects are a common reason to change dosing regimens.
ARV drugs are divided into common groups such as:
Nucleotide reverse transcriptase inhibitors (NRTIs) such as D4T, AZT, 3TC, TDF.
Non-nucleotide reverse transcriptase inhibitors (NNRTIs) such as NVP, EFV
Grase enzyme activity inhibitors (INSTIs) such as Dolutegravir

2. Tenofovir - TDF . side effects

TDF has no restrictions on taking the drug with food.
When using TDF, users can have:

Tác dụng phụ thường gặp	Tác dụng phụ ít gặp
Ngứa Mệt mỏi Khó ngủ Buồn nôn Tiêu chảy Đau Đau lưng Đau dạ dày Loãng xương Tăng men	Trầm cảm Đau khớp Đau cơ Chán ăn, Giảm cân Hạ kali máu Toan hoá máu Gan nhiễm mỡ Suy thận Giảm bạch cầu máu Đau dây thần kinh ngoại biên

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Bài viết này được viết cho người đọc tại Sài Gòn, Hà Nội, Hồ Chí Minh, Phú Quốc, Nha Trang, Hạ Long, Hải Phòng, Đà Nẵng.