Antiretroviral therapy (ART) has revolutionized HIV care, giving millions of people living with the virus longer, healthier lives.
Yet, while the benefits are clear, some patients may experience side effects such as high blood pressure or weight gain—conditions that require attention but are generally manageable.
Globally, nearly 41 million people were living with HIV in 2024, with Eastern and Southern Africa accounting for 21.1 million and Western and Central Africa for 5.2 million.
ART is the cornerstone of treatment, suppressing the virus, protecting the immune system, and preventing serious illnesses.
Benefits Far Outweigh the Risks
Dr. Melani Ratih Mahanani, a medical doctor and epidemiologist, conducted research exploring how HIV medications affect heart and metabolic health.
“Some drugs may lead to small changes in weight or blood pressure, but these are not signs of treatment failure,” Dr. Mahanani said. “This highlights the importance of combining HIV care with routine chronic disease monitoring.”
ART not only improves patients’ health but also reduces HIV transmission risk during sex and pregnancy.
With consistent daily use, people living with HIV can remain active, work, study, and participate fully in their communities.
In Malawi, for instance, life expectancy rose from 66.04 years in 2022 to 66.37 years in 2025, reflecting the positive impact of ART.
What the Research Found
The study followed 432 people living with HIV—317 women—to assess changes after switching to dolutegravir, a WHO-recommended drug.
- Blood Pressure: Newly diagnosed hypertension appeared in 11% of patients after the switch, compared to 5.4% on prior medications. Other drugs, like efavirenz and tenofovir, showed slower but steady increases in heart-related risks over time.
- Weight Gain: Minimal weight gain was observed.
Most patients experienced no significant changes. Factors like age, diet, activity level, genetics, and overall health influenced outcomes, meaning side effects vary from person to person.
Staying Healthy While on ART
Experts emphasize that side effects are not a reason to stop treatment. Key steps for maintaining health on ART include:
- Taking medications exactly as prescribed.
- Monitoring weight, blood pressure, and overall wellbeing during routine clinic visits.
- Adopting healthy habits such as regular physical activity, balanced diets, and avoiding smoking and excessive alcohol.
- Consulting healthcare providers promptly if experiencing rapid weight changes, dizziness, or headaches.
Support from community groups and peer counselors can help people stay motivated and share practical ways to maintain health while on treatment.
The Role of Healthcare Providers and Governments
Dr. Mahanani calls on health systems and governments to integrate chronic disease care with HIV treatment.
Routine checks for blood pressure, heart health, and weight should be standard, and clinics should have the tools to manage early signs of hypertension.
Governments can support this through clear guidelines, healthcare worker training, and consistent access to essential medicines.
By combining ART with attention to overall health, people living with HIV can enjoy long, productive lives while staying in control of their wellbeing.
This article is republished from The Conversation under a Creative Commons license. Read the original article.