Table 3.

Gender differences in antiretroviral toxicity

Regimen	Nature of difference in women versus men
NRTIs and NNRTIs
NRTIs	↑ risk of developing body habitus changes (p<0.0001) [52]
Zidovudine (AZT), zalcitabine,	↑ likelihood of reducing dose or stopping didanosine-containing regimen [50]
didanosine	3-fold ↑ in risk for AEs because of didanosine (p=0.03) [45]
	↑ likelihood of developing anaemia with AZT (p=0.026) [53]
Nevirapine	7-fold ↑ in risk of rash (p=0.003) [54] 3 to 5 times ↑ likelihood of discontinuation due to rash (p=0.005) [54]
	2-fold ↑ in grade 4 elevations of liver enzymes [55]
Efavirenz	Potential risk of ↑ AEs due to ↑ plasma concentration [23]
	2.2 times ↑ risk of discontinuing treatment, in part due to psychiatric AEs [56]
Protease inhibitors
Ritonavir	↑ frequency of AEs (p=0.008) [57]
Fosamprenavir (± ritonavir)	Minimal [37]
Darunavir/r	Nausea and vomiting more common (NS) [58] Trend of higher discontinuation rates due to AEs [58]
Atazanavir/r	Minimal [59]
Lopinavir/r	Minimal – slight ↑ in nausea and ↓ in diarrhea [59]
Protease inhibitor-containing ART	↑ mean TG (p <0.02) ↑ mean LDL (p <0.0001) ↑ mean Leptin (p <0.02) ↑ fasting insulin levels and LDL/HDL ratio (p=0.02) [49]
	1.5-fold ↑ in risk of development of lipodystrophy syndrome [47]

NRTIs=nucleoside reverse transcriptase inhibitor; NNRTI=non-nucleoside reverse transcriptase inhibitor; ART=antiretroviral therapy; AE=adverse event; TG=triglycerides; LDL=low-density lipoproteins; HDL=high-density lipoprotein, NS=non-significant.