Side Effects of HIV Drugs

The side effects of HIV drugs are usually manageable. However, drugs containing TDF may lead to kidney, bone, and liver damage. Victims of TDF’s side effects are seeking justice from the drug’s manufacturer, Gilead Sciences, claiming the company withheld a safer alternative to increase profits.

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What Are the Side Effects of HIV Drugs?

Like any medication, HIV drugs have potential side effects. Many of them are mild and may even go away once the body adjusts to the drugs, but some are more serious.

HIV drug side effects may include:

  • Appetite loss
  • Blood sugar increase
  • Body fat redistribution
  • Diabetes
  • Diarrhea
  • Heart disease
  • Muscle tissue breakdown
  • Nausea
  • Vomiting

However, an HIV drug known as tenofovir disoproxil fumarate (TDF) may damage the kidneys, bones, and liver.

Side effects of TDF include:

  • Acute kidney dysfunction
  • Chronic kidney dysfunction
  • Fanconi syndrome
  • Kidney failure
  • Low bone density
  • Osteoporosis
  • Osteopenia
  • Tubular dysfunction
  • Bone damage and fractures
  • Tooth loss

These side effects can range from mild bone density loss to life-threatening organ failure. Older and less healthy people have a greater risk of developing serious side effects from TDF.

Quick Facts

  • The potential side effects of HIV drugs range from mild nausea to kidney failure.
  • HIV drugs containing TDF may lead to bone problems as severe as osteoporosis.
  • TDF drugs may damage the kidneys and liver — in rare cases, causing organ failure.
  • Many people suffering from the side effects of TDF are filing lawsuits against the drug’s manufacturer, which allegedly withheld a safer alternative to increase profits.

Bone Injuries

HIV drugs such as those that contain TDF may lower the body’s ability to create new bone tissue.

Resulting bone problems may include:

  • Bone density loss and demineralization: Demineralization happens when minerals are removed from hard tissues such as bones and teeth. This process causes bone density loss and, if it continues, may lead to osteoporosis and tooth loss.
  • Osteopenia: Osteopenia is the condition of having weaker than normal bones. While osteopenia has no symptoms and bones still do not break easily, the condition may progress to osteoporosis.
  • Osteoporosis: Someone with osteoporosis has very weak, brittle bones. This condition may cause back pain, hunched posture, and easily broken bones.

Kidney Injuries

TDF can build up in the kidney’s fragile tubules, resulting in various injuries.

TDF may cause kidney injuries such as:

  • Chronic Kidney Disease (CKD): CKD occurs when the kidneys are so damaged that they cannot properly filter blood. This leads to the build-up of waste in the body. There are no obvious symptoms of CKD.
  • Acute Kidney Injury (AKI): AKI is a critical condition where, over the course of a few hours or days, the kidneys are unable to filter blood. Symptoms include swelling, nausea, fatigue, and decreased urination.
  • Tubular Dysfunction: This condition causes too much acidity in the blood, which may lead to kidney stones, bone disease, chronic kidney disease, or even kidney failure.
  • Fanconi Syndrome: This syndrome causes certain substances that are normally absorbed into the bloodstream by the kidneys to be released into the urine instead. This may lead to tubular dysfunction, various bone diseases, and other complications.

Liver Injuries

According to the U.S. Department of Health and Human Services (HHS), TDF may lead to severe liver problems.

Liver injuries associated with TDF drugs include:

  • Liver cancer: This rare cancer originates in liver cells and may require removal of part of the liver or a liver transplant.
  • End-stage liver disease (ESLD): This is a condition in which the liver has become too damaged to properly function. Without a liver transplant, this condition is fatal.

Of 45,544 HIV-positive participants in one 2004-2014 Data collection on Adverse events of Anti-HIV Drugs (DAD) study, 319 reported chronic liver failure or liver cancer. An analysis of the data listed TDF as one of three drugs associated with the side effects.

HIV Drug Side Effects and Legal Action

Many of the side effects of HIV drugs are mild — however, those containing TDF may cause serious damage to the kidneys and bones.

More victims of these dangerous side effects are seeking justice against Gilead Sciences, the drug’s developer. They claim that tenofovir alafenamide (TAF), TDF’s safer alternative, was withheld so that Gilead could capitalize on TDF — a drug the company knew had adverse health effects.

If you have suffered from the side effects of TDF, legal action could help you receive financial compensation for your illness and medical treatments. Icon

Fact-Checked and Legally Reviewed by: makes it easier to take legal action. We have information, lawsuit guides, and breaking news about drugs, products, and other issues that could affect you.

  1. Tourret, J., Deray, G., & Isnard-Bagnis, C. (2013, October). Tenofovir Effect on the Kidneys of HIV-Infected Patients: A Double-Edged Sword?. Journal of the American Society of Nephrology, 24(10). Retrieved September 5, 2019, from
  2. Hamzah, L., Jose, S., Hegazi, A., Bailey, A., Chadwick, D., Williams, D… Post, F. A. (2016, February 25). Clinical Risk Factors for Severe Tenofovir (TDF) Associated Renal Tubulopathy. Retrieved September 6, 2019, from
  3. Venter, W. D.F., Fabian, J., & Feldman, C. An overview of tenofovir and renal disease for the HIV-treating clinician. Retrieved September 6, 2019, from
  4. Highleyman, L. New research at CROI 2016: How PrEP changes kidney function. Retrieved September 6, 2019, from
  5. Abou Neel, E. A., Aljabo, A., Strange, A., Ibrahim, S., Coathup, M., Young, A.M.,…Mudera, V. (2016, September 19). Demineralization–remineralization dynamics in teeth and bone. Retrieved September 6, 2019, from
  6. Mayo Clinic Staff. (2019, June 19). Osteoporosis. Retrieved September 6, 2019, from
  7. Mothobi, N. Z., Masters, J., & Marriott, D. J. (2018, September). Fanconi syndrome due to tenofovir disoproxil fumarate reversed by switching to tenofovir alafenamide fumarate in an HIV-infected patient. Retrieved September 6, 2019, from
  8. The National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Chronic Kidney Disease (CKD). Retrieved September 6, 2019, from
  9. Mayo Clinic Staff. (2019, August 15). Chronic kidney disease. Retrieved September 6, 2019, from
  10. National Kidney Foundation. (n.d.). Acute Kidney Injury. Retrieved September 5, 2019, from
  11. The National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Renal Tubular Acidosis. Retrieved September 6, 2019, from
  12. LoCicero, R. (2018, January 19). Fanconi syndrome. Retrieved September 6, 2019, from
  13. Hechanova, L. A. (2019, February). Fanconi Syndrome. Retrieved September 6, 2019, from
  14. The Regents of the University of California. (2019). End-stage Liver Disease (ESLD). Retrieved September 6, 2019, from–procedures/end-stage-liver-disease-(esld).aspx
  15. Mayo Clinic Staff. (2019, May 4). Liver cancer. Retrieved September 6, 2019, from
  16. Hosein, S. R. Does tenofovir (TDF) cause liver injury? (2016, February 10). Retrieved September 5, 2019, from
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