All antiretroviral drugs have side effects. Most are mild, especially in children. However some can be severe and even fatal in rare cases. Nausea, vomiting, headache, fatigue and mild rashes are common. Rash, raised liver enzymes, peripheral neuropathy and anaemia must be looked for. Most serious side effects occur within one month of starting treatment.
Poor drug compliance (not taking the medication on time every day) may lead to drug resistance and treatment failure.
Immune reconstitution inflammatory syndrome (IRIS) may present soon after antiretroviral therapy has started. An inflammatory response may develop as the immune system starts to recover. During this period severe bacterial, viral or opportunistic infects may present or become worse, especially TB.