Email 358: ARV Side Effects and the One Pill ARV

Hi Pozzie,

I am an HIV+ Filipino in my late 40s. I have been on ARV drugs for about a year now. I only had the usual nausea side effects of Efavirenz during the first few days but i never got any rashes or itchiness that some people had.  My problem now is that after taking a regimen of three different Arv drugs for a year, my legs have developed a feeling of numbness that won't go away. I am also feeling some sort of nervousness and depression sometimes so i had to take anti-depressant medications. My psychiatrist said that the ARV meds aggravate these feelings.

I know that in the western countries, HIV+ people are given a once a day drug that produces no side effects.  My question is, why are we here in the Philippines still using the old ARV regimens? When will the one a day 

pills be available for us here so we need not experience these terrible side effects?

I hope you have an idea about my concern. I wanna be proactive with the management of my condition as much as possible.  Thank you and more power to you.

Proactive Guy

POZZIEPINOY'S RESPONSE

Hi Proactive Guy.

Thank you for your email. Thank you for finding the blog.

Let me answer you concerns in the order that you asked them.

First when it comes to the other effects of the ARV's, you need to consult your HIV doctor about it. These effects are of course not normal so you really have to coordinate with your doctor about it.

With regards to your second question, in the western/first world countries, there are already newer, one day pill that contains the cocktail. These ARV's are usually paid for by their insurance (and or subsidized by their governments) or their own AIDS organizations. If a PLHIV will have to buy them on his/her own, it would cost him or her up to $2,000 per month. Expensive huh?

In the Philippines, our government can't subsidize the ARV's for us right now because of the cost. Because of this, all the ARV's coming from all the HIV/AIDS Treatment Hubs are subsidized by the Global Fund, an international organization that provides a program that gives free ARV's in developing countries, including the Philippines. The ARV's are not available in local pharmacies as they are all expensive. Of course since they are given for free, our ARV's are cheaper and are generic, and if you would check out the bottles of your ARV's, they are manufactured in India. Although generic, they serve the same purpose as the one day pill, of course harder to take as they are still the 3 pill cocktail instead of the one pill cocktail available in western countries.

For now, we can't complain. As I always say, "beggars can't be choosers". Unless of course you want to buy your ARV's on your own from other countries which will cost you around P80,000 per month for your cocktail, then I rest my case.

I am glad that you are proactive about the management of your health. For now focus first on what you can do to minimize the side effects of your ARV's and second just be grateful that the ARV's that we are getting from the hubs are still free.

I hope I was able to answer your concerns. Feel free to email me again if you have other questions.

Stay healthy,

Pozziepinoy