Green Pages Where There Is No Doctor 2011 397
How to take ART
ART works as a combination of at least
3 medicines. Four common combinations are listed
in the box on the right. Ask your health worker what
medicines are available and work best where you
live. Some combinations come in 1 or 2 tablets so
there are fewer pills to take.
Whatever combination you use, take every
medicine every day, at the same times of day.
Twice-a-day medicines should be taken every 12
hours. Having too little medicine in your body for
some hours can cause drug resistance and the
drugs will no longer work for you or for others in
your community. Do not stop taking any medicine
that is part of an ART combination without finding
out if your medicines should be stopped separately
or all at once.
Side effects of ART
ART can have side effects. Some side effects
decrease and go away completely with time.
Others appear only after you have taken a medicine
for a long time. Some common side effects are
bothersome but are not serious, such as diarrhea,
tiredness, headaches, and stomach problems. Talk
to your health worker about how to handle these
problems. But keep taking all your medicines until
your health worker tells you to change or stop.
Other side effects can be life-threatening, such
as severe liver problems, severe tiredness with
shortness of breath, skin allergies and rashes,
tingling or burning in the hands and feet, and
anemia. If you have serious side effects, see a
health worker right away.
Preventing HIV right after a person has
been exposed to it
When a health worker is exposed to HIV
during her work, for example because she is
stuck with a needle, or a person has unprotected
sex with someone who is likely to have HIV, it is
possible to take ART medicines for a short time to
prevent getting HIV. This is called Post Exposure
Prophylaxis, or PEP.
If it is likely that you have been exposed to HIV
(see p. 399 for how HIV is spread), start PEP as
soon as possible. The decision about whether
to start PEP can be complicated—talk with a
health worker you trust. PEP works best if you
start taking medicines within a few hours, and
no later than 3 days after exposure. Start one of
the ART combinations on this page, preferably
AZT+3TC+EVF or TDF+3TC+EVF. Or, other
combinations may be available and recommended
in your area. Whichever combination you use, take
the medicines for 28 days.
ART combinations for adults
and adolescents (not for children)
These medicines are taken 2 times a day (except
as noted) every day, with 12 hours between
the doses.
AZT (ZDV, zidovudine), 250 to 300 mg.
+ 3TC (lamivudine), 150 mg.
+ N VP (nevirapine), 200 mg.
Take NVP once a day for 14 days, then
2 times a day.
or
AZT (ZDV, zidovudine), 250 to 300 mg.
+ 3TC (lamivudine), 150 mg.
+ E VF (efavirenz), 600 mg., once a day
or
TDF (tenofovir), 300 mg.,once a day
+ 3TC (lamivudine), 150 mg.
+ N VP (nevirapine), 200 mg.
Take NVP once a day for 14 days, then
2 times a day.
or
TDF (tenofovir), 300 mg., once a day
+ 3TC (lamivudine), 150 mg.
+ E VF (efavirenz), 600 mg., once a day
Side effects of specific ART
medicines:
AZT: anemia, low white blood count
NVP: skin rash, liver problems
EFV: not safe in first 3 months of pregnancy
TDF: kidney problems, must be over 18
to use
IMPORTANT: Many people on ART take d4t
(stavudine) instead of AZT. However, d4T can
cause serious side effects after long-term use.
Most HIV treatment programs are trying not to
use ART combinations that include stavudine.
If you use stavudine, do not take more than
30 mg. twice a day.