Nausea and Vomiting

Nausea and vomiting are two of the most common gut-related side effects of HIV treatment. Interestingly, nausea and vomiting have very little to do with the actual effects of medications on the stomach or the rest of the gut. While medications used to treat HIV and AIDS can certainly irritate the lining of the gut and cause pain or discomfort, the reason why these drugs cause nausea and vomiting actually involves a part of the brain called the "vomiting center." When the vomiting center detects certain imbalances in the body—including toxic chemicals entering the bloodstream—it signals the stomach to reject its contents. This can lead to a general feeling of sickness or "queasiness" in the stomach and, sometimes, the forceful elimination (emesis) of the stomach's contents through the mouth.

While vomiting is considered to be more severe and dangerous than nausea, many people report that feeling nauseous is far more unpleasant than vomiting. As for vomiting, if it is severe and lasts for more than a few days, it can deplete the body's fluid levels—a condition called dehydration. Prolonged periods of nausea or vomiting can also cause someone to lose his or her appetite and become undernourished. Vomiting can also prevent HIV drugs from remaining in the gut long enough to allow for proper absorption as well. If these drugs are not absorbed properly, their levels in the blood can fluctuate, ultimately leading to drug resistance.

Fortunately, the nausea and vomiting that accompanies the use of ARV medications are usually mild and tend to get better after a few days or weeks of continued treatment. The severity of nausea and vomiting usually depends on the drug or combination of drugs used, the number of times each day the drug is used, whether or not food should be taken with the drugs, along with a number of other variables particular to each patient (i.e., gender, body weight, height, age, experience with other medications in the past, etc.).

Most of the drugs used to treat HIV are known to cause either nausea and/or vomiting. However, this does not mean that everyone taking HIV drugs will experience either of these problems. It also doesn't mean that someone who experiences nausea or vomiting while using one particular drug or combination of drugs will experience these symptoms with all of the ARVs.

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