Home / Episode 20

Siyayinqoba Beat It! Episode 20 -

ARV Side Effects

On Siyayinqoba Beat It! 2006 this week we talked about the side effects of antiretrovirals. The majority of people on ARVs deal with only mild side effects and it is remarkable that our bodies tolerate this chronic medication so well. There is no medication that does not have side effects. Dr Hermann Reuter and Dr Trevor Majoro talks us through how to recognise and deal with some of the side effects, as well as the importance of finding the right medicine combinations for you.

Shalom Ncala:Sanibonani, siyani amukela iqenjeni leSiyayinqoba Beat It!support group. Ingama lami ngingu Shalom Ncala. Eqenjeni loSiyayinqoba Beat It! sonke siphila kahle neHIV. Sanibonani nonke. Ninjani kodwa nahlanje. Njalo ngeviki siyahlangana ukuzoxoxisana ngezindaba ezithinta iziphilo zethu, ukusukhela ukuthola amaARVs nokukhulelwa. uSiyayinqobq nguhlelo lwakho lukhu phila ngagcono neHIV. Uma uphila negciwane le HIV or you have a partner, a family member or friend who is living with HIV this Siyayinqoba is for you. Namhlanje sikhuluma nomuphumela emibi yama anti-retrovirals. Abantu abaningi abaphuza amaARVs babhekhana nemiphumela imibi emicane. Iyamangalisa ukuthi imizimba yethu iyakhona ukuhambisana nalawu makhambi kangakho. Alikho ikhambi elinganamphumela emibi sonke sindinga ukufundiswa nokhu nukuqaphelisisa ukumela imiphumela imibi. Umasiphila ne-HIV ukumele sithembele kubasebenzi bezekhunakhekhela iphilo kuphela ukuthi bahlole imuphumela imibi yethu. Masizweni ukuthi bathini ababukheli bethu ngemiphumela emibi.{IsiZulu} Hello and welcome to the Siyayinqoba Beat It! support group. My name is Shalom Ncala. In the Siyayinqoba support group we are all living positively with HIV. Each week we get together to discuss issues that affect our lives from getting ARV’s to pregnancy. Siyayinqoba is your guide to better living with HIV/AIDS. If you are living with HIV] or you have a partner, a family member or friend who is living with HIV this Siyayinqoba is for you. Today we are talking about the side effects of antiretrovirals. The majority of people on ARVs deal with only mild side effects. It is remarkable that our bodies tolerate this chronic medication so well. There is no medication that does not have side effects. We all need to be educated in recognizing and dealing with side effects. When living with HIV, we cannot rely solely on our healthcare workers to monitor our side effects. Let’s see what our viewers have to say about side effects.]

Question:Yini imiphumela ingathi ivele mawusebenzisa amaARVs, yaye ungayiceda ngantoni lento? {IsiXosa} [What kind of side effects can I get from ARVs? And what can I do if I have side effects?]

Shalom Ncala: Olapha ukuzo xoxisana nathi ngu doctor Trevor Majoro wase klinic ye HIV no phinde futhi abeyinyanga yesithu ovela eGoli. Sawubona doctor Majoro,ninjani baba. Ukuthola ulwazi olwengeziwe iqembu lesiyayiqoba lahlangana no doctor Hermann Retuer ovela oLusikisiki okhulumisana nathi ngemi phumela imibi kakhulu, efana ne Lactics Acidosis ne Lipodystrophy. Masibukheleni. {IsiZulu}[To help us discuss this matter is Dr Trevor Majoro, an HIV clinician and traditional healer from Johannesburg. Hello Dr Majoro. To find our more the Siyayinqoba team met Dr Hermann Retuer from Lusikisiki. He spoke to us about serious side effects like Lactics acidosis and Lipodystrophy. Let’s take a look.]

Lusikisiki, Eastern Cape, ‘Lipodystrophy and Lactic Acidosis’

Nonyameko Ntiyo:Ndingene ku treatment yeARVs ngonyaka ka 2005, ndiqalise ukutya itreatment yani nge Nevirapine, 3TC and d4T. Ndiqubekhile nazo zindiphethe kakhuhle, kuthe kunyaka wakha 2006, ndagula. Ndigula nje dinesisu esibuhlungu, ndinesiphundu eziphelileyo, kwacaca ukuba ndiye kugqirha wami. So kwafumaniswa ukuthi ndine Lipodystrophy, emveni khokho kwacaca ukuba ndizo shitshwa ke ngoku kupilisi zami. So zona zindiphethe kakhuhle ne ziphundu zami ziye zabuya isisu sami sinciphile namabele bewamakhulu abuyile aright ngokhu yonke into yami ibuyele kusiqhelo.{IsiZulu} [I started on ARV treatment in 2005, with Nevirapine, 3TC and d4T. I took the ARVs without experiencing any problems. This year, 2006, I started feeling sick. I had stomach aches and my buttocks got smaller. Then I decided to visit my doctor. They found that I have lipodystrophy and I have to change my medication. I’m feeling well now on the treatment I’m taking. My buttocks went back to their normal size, my stomach is fine and my breasts are smaller again, everything is back to normal.]

Dr Hermann Reuter:Lipodystrophy is a side-effect that we see in patients who are using Stavudine, which is a first-line treatment, or d4T, and d4T has an effect on the metabolism of the body and the way your body utilises energy utilises fat stores. And it can cause fat changes of your body appearance. It’s usually associated with the face becoming drawn in, the cheeks being drawn in, and you see the fat in the breasts and the tummy to increase.

Nonzaliseko Nondu Ntwana:Ndingu Nonzaliseko Nondu Ntwana wase Ngobozana ohlala apha eMonwabisi. Nditeste ngo nyaka ka2005, ngo February. Ndandigula ndafumanisa ukuthi ndi HIV positive. Ndaqala iARVs zami iNevirapine, 3TC ne d4T. Ndazitya ndaright andizange ndibe neside effects azange khube nanto. Into iyenzaka ndiqibe inyaka nditya iARVs zami ndiye ndafumanisa ukuba ndinesishwapha ngoku, ndinesisi esikhule namabele amakhulu. Ndinazinyawo ezibuhlungu. Okay ndayakugqirha, ugqirhq wathi uyandi stopisa for four weeks ndiyekhile amaARVs. Wase adlixelela ukuba iside effects zami zezed4T. {IsiXhosa} [I’m Nonzaliseko Nondu Ntwana from Ngobozana, Monwabisi. I tested for HIV in Feb 2005. I was sick, and I tested HIV positive. I started ARVs: Nevirapine, 3TC and d4T. I took them and I didn’t experience any side-effects for a while. Then after a year of taking the ARVs, my breasts and my stomach got bigger and my feet were aching. I went to my doctor, he took me off ARVs for four weeks and told me that I have a side effect of d4T.]

Dr Hermann Reuter:So a lot of us doctors are motivating that we should look at using perhaps another medication rather than d4T. Something like Tenofovir. At the moment d4T is being used because of its effectiveness. It’s very nice to start people on Antiretrovirals because it doesn’t have any symptoms when we start Antiretrovirals. It’s also one of the cheapest Antiretrovirals. As we are treating thousands of people we have to look at cost-effectiveness of our treatment. Lactic acidosis is another side effect that we see with d4T and DDI, which is used in the second line regimen. But as most of our patients are still on the first regimen, that is the common drug where we see lactic acidosis happening. Lactic acidosis is again a change in the metabolism, the way your body uses energy. Instead of normal cellular process, where the body utilises the energy properly, it builds up lactic acid in the body. The patient isn’t aware of it, because the liver and the urine can compensate for it and can excrete it in sufficient levels. But if this process carries on for too long, usually we pick it up by the patient losing weight. It is something that doesn’t happen early when you start using Antiretrovirals, it happens after the first six months.

Support group

Shalom Ncala:I know for a fact abantu out there bane the same stumbling block when it come ukuthi ngiyawaqala amaARVs. Simply because lengama lama side effects labekwa eceleni lemaARVs. Ngifuna ukwazi basicacisa kabazi ukuthi amaphi amaARVs are severe ukudlula amanye kuqaphilisiswe kahle. {IsiZulu}
[I know for a fact that people out there have the same stumbling block when it comes to starting ARVs, simply because ARVs are associated with side-effects. I’d like to know which side-effects are the most severe.]

Dr Trevor Majoro:We have seen kwi insert for example i-Lactic Acidosis; we have seen Lipodystrophy esingakayiboni laphaya yi peripheral neuropathy. iPerpheral neuropathy abantu baye babe namapains ezinyaweni and kaningi and kaningi bazakutshela ukuthi bazwa ngathi kuyashisa ukuyahlaba almost yifane nomuntu onesifo seshukela. And that side effect iyamanejeka there are drugs sikhona ukuwa sebenzisa. Okwesibili ilactic acidosis iyiside effects enengozi kakhulu sonke siyanzi and if ayipikhaphanga early it will have fatal outcomes. But ekubelulekile kakhulu engifuna ukugcizelela kakhulu ukuthi number one amaARVs i-benefit yawo ioutweigh far outweighs side effects, number two in a case were there is side effects ayamanejeka. That is way kubalulekile before umntu aththa amaARVs fanele ukuthi a-educate as part of counselling. The early you pick the sings or the symptoms ku-suggester ukuthi une problem] {IsiZulu} [In the insert we have seen lactic acidosis and Lipodystrophy, and what we didn’t see is something called peripheral neuropathy. With peripheral neuropathy, patients experience pains in their feet, they complain about a burning sensation in their feet, almost the same as someone who is diabetic. That side-effect is manageable, there are drugs that we can use. Secondly, we all know that lactic acidosis is a very dangerous side-effect and if it is not picked up early, it can have fatal outcomes. The most important thing that I would like to emphasise is that the benefits of Antiretrovirals outweigh the side effects. Secondly, the side effects can be managed. That is why it’s important that before people start taking ARVs, they must be educated about antiretrovirals as part of counselling. The earlier you pick up signs or symptoms that you have a problem, the earlier you get help and the earlier you get help, the better for you.]

Thami Mthembu:What causes the side-effects in our bodies, what causes that reaction?

Dr Trevor Majoro:Umubuzo wakho muhle, ngizoqala kuqala ukusebezisa i-qoute ye-colleague yami uFrancesca. [Good question. I would like to use a quote from my colleague Francesca. ] She normally would say the drugs are toxic, but the virus is toxicer. . . And I think that that’s a beautiful quote… The reason why people get side effects in their bodies relates to the chemical composition of the drugs, first, and where those drugs act in the body. Masithathe amaARVs for example as a group of drugs, lama drugs lawa asebenza within the CD4 cell. [For example, let’s take ARVs as a group of drugs. These drugs work within the CD4 cell]… so what must happen is, the drug must enter the CD4 cell, and inhibit the function of reverse transcriptase inside the cell, directly in the case of non-nukes, and indirectly in the case of nukes. So already uzobana ukuthi the fact that idrug imele ukuthi ingene ngaphakhathi kwecell and iyichemical and iforeign izo interefere with metabolic process ezi occurer within the cell. And the fanal outcome ezekha at . [The fact that the drug has to enter the cell, it’s made of chemicals and it’s a foreign body, it means it’s going to interfere with metabolic processes that occur within the cell. And the final outcome that happens at] a larger scale, which is in the body beneath the skin, the eyes, the lungs, the liver and so on, will manifest itself as per severity of that reaction. {IsiZulu}

Shalom Ncala:[We talk more about ARVs and side - effects after the break. We’ll be right back, so stay tuned.] {Sesotho}

Shalom Ncala:[Welcome back to the Siyayinqoba Beat It! support group.] {Sesotho} Uhlelo lawonke umuntu ongenwe futhi othintakayo yi-HIV. Namuhlanje sikukhuluma ngemiphumela emibi yama ARVs {IsiZulu} [The programme for everyone infected and affected by HIV. Today we are talking about ARVs side effects.]

Vuyani Jacobs:I was one of the first 20 people to take ARVs in Cape Town, on a public scale through MSF, and I think one of the things we learnt about side - effects, it was never something that was kept out of the people. The reason people must understand side-effects is so that you can be able to manage them Ukwazi ukusigconda ukuthi ziqala nini. [to realise when you start.] Way back in the early 2000s bendifuna ukugamba ndi file dizzy. Kodwa ke lentoleyo yenzwa yintoni bendina 11 million viruses in my body. i-CD4 count yami yangu 117 which means that umzimba wami bewuphethwe yi-virus. Lento ithetha ukuthi ukugamba kwami kwakhukulwa anti-retriviral drugs zibulala ntoni i-virus apha emzimbeni wami. But then kwathiwa khum’ eklinic mandifuna ukugamba ndithatha isonka esi-brown ndingasicabi ndisidle kancani kancani, ngoba mawufuna ukugamba uvela ukufunu ukutya. What im trying to say is just apha Emzansi Afrika {IsiXhosa} [I was always nauseous and dizzy. The reason was that I had 11 million viruses in my body. My CD4 count was 117, which meant that my body was full of virus. That means that nausea was brought on by the fight between the ARVs and the virus.] So that needed a reaction from the body, hence I had to be nauseous. [But I was told at the clinic that whenever I feel like vomiting, I should eat unbuttered brown bread, because when you feel like vomiting, you lose your appetite. It is important for people to know the side-effects; it’s just that here in South Africa] we are over-playing it.

Shalom Ncala: I should think we need to emphasise kuthi even though bekubi ukuthi ngiqale amaanti-retrovirals, bengi ne rash esabekayo due to side effects yamaARVs engigawaphuza. I-skin sami, bengijwayele ukuthi i-skin sami besi right singana niks, due to ama-Anti-retrovirals kwaqala ukuthi i-skin sibe-dry ama hormones angabi normal, but those are things that you have to be prepared for, ama-treatment supporters akho afanele ukuthi akucedise ukuthi things ara gonna be okay zama lokhu ukuzoba right. Treatment supporters I mean odokotela bakho nabantu ozosebenzisana nabo nasekhaya futhi. {IsiZulu}[We need to emphasise that even though it’s difficult when you start ARVs. For instance, I had a very scary rash, due to one of the ARVs I was using. Normally I don’t have problems with my skin, but due to ARVs, my skin started being dry, and I had abnormal hormones. But those are things that you have to be prepared for. Your treatment supporters should be supportive. ‘Things are gong to be okay’. By treatment supporters I mean your doctor, and the people that usually help you at home. They must tell you that things are going to be okay.]

Thami Mthembu:And I don’t think that people realise how much all this publicity about side effects affect people that are living with HIV. I mean, I’m living with HIV, and I’m not on treatment. And it makes it so difficult for ukuthi ngimanenje [me to manage] my illness, in terms of going for my regular check-ups and my CD4 counts, and that is due to the into eyenza ukuthi kube nzima [fact that] I’m very scared that very soon I will have to start treatment. As much as I’m sebenza kwi [working in the] industry, with people that are on treatment, people who have come to terms with the fact that they are HIV positive and are on treatment. But I still have insecurities about taking ARVs, because I mean ngiyezwa into yishiwo wobbuti Vuyani ukugamba nokukishwa yisisu [I hear what Vuyani is saying, vomiting and stomach aches,] those are things that I can tolerate. But as a person who is very obsessed with the way that I look, and if I qala ngibe nama {IsiZulu} [start having] rashes on my skin, I can’t. I can’t!

Nokhwezi Hoboyi:Thami, not everybody uthola ama-side effects, wonke umuntu unedlela yakhe uzimba wakhe usebenza ngaye, singayi qala i-treatment at the same time mina ngigabi na niks. Abantu for example uMinister ufuneka asho ukuthi well amaARVs anamaside effects which is why before uwathatha uzakhuxela ukuthi this is what you must expect one, two three no four, ukwenzela ukuthi bazikhuqala une-rash, as soon as ikuvela. And tell the ukuthi ngiyiqalile i-treatment nakhu manje ngivela ama-skin rashes {IsiXhosa} [Thami, not everybody gets side effects. People’s bodies respond in different ways. We can start treatment at the same time, and I may experience side effects, and you won’t. The minister of health should say ARVs have side effects. Which is why before you take them, they’ll tell you what you should expect, even skin rash.] As son as it starts, go to your clinic, go to your nurse or your doctor and [tell them you have started treatment and you’re experiencing skin rashes.] They’re going to give you something to treat that.

Dr Trevor Majoro:I HIV ngokwayo, inama-skin manifestations abakhona ngokuthi yona ikhona emzimbeni womuntu. So even long before umuntu athatha amaARVs angaba nama-skin changes. [HIV has many skin manifestations. A person can experience skin changes even long before they start ARVs because of the presence of the virus itself.] Let’s not be too hooked on fears of amaARVs because some of things zingayenzeka. [of ARVs because some of these things just occur.] HIV multiplies in your body everyday, not into thousands, into millions. And the rate at which HIV multiplies in your body everyday is far too much than at the rate at which your soldiers, or your CD4 cells, multiply in your body. It is important to know that your CD4 count is at this level, your viral load is at this level, because then you can intervene earlier. {IsiZulu}

Shalom Ncala:[We talk more about ARV side-effects,] {Sesotho} after the break. We will be right back .

Shalom Ncala:[Welcome back to the Siyayinqoba Beat It! support group.] {Sesotho} The programme for everyone infected and affected. Namhlanje sikhuluma ngemiphumela emibi yama ARVs.Iqembu leSiyayinqoba ivakashele eLusikisiki ukuyobheka isiguli ezisa Lusikisiki ezine immune reconstitution syndrome ephindwe iyaziwe nge IRIS kanye nesi Stevens Johnson syndrome. {IsiZulu} [Today we are talking about ARV side – effects. The Siyayinqoba team went to Lusikisiki to look at Lusikisiki patients that have immune reconstitution syndrome, also known as IRIS, and an illness called Stevens Johnson syndrome.]

Lusikisiki, Eastern Cape: Immune Reconstitution Syndrome and Stevens Johnson Syndrome.

Nobongile Miya:Ndiqalise iARVs ngo Marck ka2006, ndizitye iveki izithantu kwiveki yesine ndarhawuzelela nda shitsha ndagathi nditshile {IsiXhosa} [I started ARVs in March 2006. I took them for three weeks, on the fourth week my body started itching. My whole body looked as if it’s been burnt.]

Dr Hermann Reuter:Stevens-Johnson syndrome is a very severe form of skin reaction that happens after using Anti-retrovirals. This is a side-effect that we see in the first month of a person using ARVs. Unlike the side-effects I described earlier, that we see late in the course of ARVs, skin reactions and allergic reactions we see in the first month or two of using ARVs.

Nurse: Hello

Woman: Ewe sister {IsiXhosa}[Hello sister.]

Nurse: Kunjani? {IsiXhosa}[How are you?]

Woman: Ndiphilile.{IsiXhosa}[I’m fine, thank you.]

Nurse: Yintoni ingxaki. {IsiXhosa}What is your problem?

Woman: Ingxaki yami sister, bendisebenzisa i-ARVs.{IsiXhosa} My problem is that I was on ARVs.

Nurse:Ziphi? {IsiXhosa} Which ones?

Woman:Nditya iNevirapine, 3TC ne d4T. Ndavele ndarhawuzelelwa ndathi ndisukha kwandathi nditshile, udoctor Hermann wandithumala esibhedlela, ndayolaliswa esibhedlela, esibhedlela inyama ngaphezulu beyivuthuluka, apha ngaphansi azinyawezi inyama isukha. Ndake ndahlala three weeks’ ndingasebenzisi iARVs. Ndaphinde nda phidela ke ndazisebenzisa. {IsiXhosa} [Nevirapine, 3TC and d4T. I developed a skin irritation, my body felt like it had been burnt. I went to Dr Hermann and he sent me to hospital. In hospital, my skin started flaking as well as the soles of my feet. I was taken off ARVs for three weeks. I resumed taking ARVs].

Nurse:Kwa kweziya {IsiXhosa} [The same treatment?]

Woman:Hayi, ndasebenzisa i3TC, d4T ne Lopinavir {IsiXhosa} No, this time it was 3TC, d4T and Lopinavir.

Nurse:Kwa tshitshwa i-Nevirapine? {IsiXhosa} So they replaced the Nevirapine?

Woman:Ewe sister {IsiXhosa} [Yes sister.]

Nurse:Ubanjani ke ngokhu? {IsiXhosa} [Do you have any pains now?]

Woman:Hayi, andiva nto sisiter. {IsiXhosa} [No I don’t, everything is fine.]

Nurse:Khuyabonakala apha ubusweni. {IsiXhosa}[I can see the difference on your face.]

Woman:Kanti sister emzimbeni key yo! {IsiXhosa} [This is nothing compared to my body.]

Nurse:Mamele ke, njengoba beyikhona apha isikhumbeni, apha emulwenyeni kwakunjani? {IsiXhosa} [And this was affecting your skin, how was it in your mouth?]

Woman:Apha emulonyeni bekukhona izilonda {IsiXhosa} [I had sores in my mouth.]

Nurse:Zibufana nezi esikhumbeni {IsiXhosa} [Similar to those on your skin.]

Woman:Ewe,zifana na ezi esikhumbeni {IsiXhosa} [Yes, similar to those on my skin.]

Nurse:So ke ngoku, into besikuchazele ke sisi, ufuneke uyi amukele, masoyi amukele ukuba abanye abantu babanazo iziguqu makusebenza iyenza, okwesibini igazi nxa liqala libuyela indaweni ukuthi uyaphila itsholongane isiyi onganela ngama ciza. {IsiXhosa} [Okay, the one thing you must understand, I think you understand it already, is that people get these changes because the medication is working and because the immune system is improving.]

Dr Hermann Reuter:If it starts getting blisters in the mouth also, then we would say it’s a grade three, and then we would have to stop the drug that we associate with this. However, if the skin reaction is so bad, it involves the eyes and it’s got all the components of the Stevens-Johnson syndrome, then we would have to stop all the non-nukes, which means the patient would not be able to use either Nevirapine or Efavirenz, and then we would use Lopinavir, which is a second-line drug, but you would use it in your first regimen.

Cetyiswa Nyenyiso:Emveni ukokubana ndandiqale i-treatment ndavela ibandi. Andizange ndibe noliyikho ukuba iARVs azindisebezeli kuba kalokhu ndandifundisiwe nge HIV and AIDS ipilisi zami iARVs. Okukubane nxangaba ndine thuba ndizidla zibakhona amangenela yezifo avele. {IsiXhosa} [After I started treatment and developed shingles, I wasn’t scared that the ARVs were not working, because I was educated about HIV/AIDS and ARVs. I knew I’d experience opportunistic infections after starting on ARVs.]

Dr Hermann Reuter:Immune reconstitution syndrome is a reaction of your immune system which we sometimes see in patients after starting ARVs. You must remember we start ARVs in a person whose immune system is much compromised, it’s hardly functional. And most symptoms of illnesses are caused by your immune system fighting that illness. One we start ARVs, and the immune system starts picking up, it starts fighting the TB germs and this response suddenly brings about the TB symptoms. And the person thinks, ‘Why am I getting sick? I’m getting ARVs and I’m getting sicker’. This is not a side-effect, this is just an opportunistic infection which is unmasked because suddenly the immune system kicks in. And this symptom, or complex of symptoms, we call immune reconstitution syndrome.

Dr Hermann Reuter:In a way, the patient gets afraid because they think, ‘Why am I getting sicker’, but for us it’s very useful because it helps us to diagnose the opportunistic infections. Without diagnosing them, we can’t treat them, and an untreated person might die because of it. So it brings out the symptoms, you can treat it. We will usually carry on with the antiretrovirals and then start treating the specific immune reconstitution syndrome, which might be meningitis, it might be a TB, it might be shingles, there’s different infections that come out once the immune system strengthens.

Cetyiswa Nyenyiso: Nxa mandiba neTB, ndazi ukuba andizoziyeka i-ARVs zami, kuba kalokhu ndasazi ukuba ngamangenolo we HIV and AIDS. {IsiXhosa} [When I got TB, I know I wouldn’t stop taking ARVs because I knew TB is an HIV opportunistic infection.]

Support group

Shalom Ncala:People still need i-knowledge kahle kahle ukuthi ba understander ukuthi yini immune reconstitution syndrome and the importance ukuthi umuntu fanele a teste early ngicela udokotela ayichaze kabanzi {IsiXhosa} [People still need more knowledge about immune reconstitution syndrome and the importance of testing early, can the doctor please explain].

Dr Trevor Majoro:IRIS, Immune Reconstitution Inflammatory Syndrome. Ayikho into ekhona isuppresser ukuzala kwe igciwane emuzimbeni, ngaphadle kwamaARVs. Once uqala ukusebenzisa amaARVs lokho kunikeza umzimba ichance yokuthi ureconstitute immunie system. [There is nothing that suppresses the virus like ARVs. Once you start using ARVs that gives the body a chance to reconstitute the immune system.] Trying to get back to normal state. Lokho ke kungayenza umuntu ukuthi agule, uthole ukuthi sewubona ukugula lokhu bekukhona, but bekungabanakhali ngoba ikimpi ekhona emzimbeni. Ngiba immune system seyiya recover manje lempi ibakhona after uthatha amaARVs. And lokho kuyenzabantu bacabange ukuthi bagulisa ngamaARVs, Hae! Lokhu bekhuluku kukhona ukugula vele igazini. Yikuthi nje amasotsha womuzimba ayalwa manje sikhuyabonakhala lento ayifuneki. That must not make anybody stop ukuthatha amaARVs. It important ukuthi abantu bafundiswe ukuthi mabathatha loma-drugs [That can cause a person to get sick, and you start seeing other illnesses that were not manifested because the body was not fighting. The body reacts after starting ARVs. This causes people to think that ARVs are making them more sick. Uh-eh! There was always sicknesses in the body. The difference is that the immune system is strong enough to fight back. That must not make anybody stop taking ARVs].it is important when abantu [people] they take those drugs what signs or what feelings must they complain about because nausea, abdominal cramp, painful legs, weight loss changes, Those are the things a person akhona ukuzibona especially ukuthi uzazika ngakanani.{IsiZulu} [will see especially if you know you body] This point brings me to the fact that, it’s important for healthcare workers to give clients a chance to talk. It’s not about the healthcare worker, it’s about the client.

Shalom Ncala:Thami, bengicala ukwazi, having heard all the information esiyothole namhlanje udokotela achaza ngabazi. [Thami, I’d like to know, after you’ve heard the doctor talking.] What is your view on uhambe uyo thatha CD4 count uwazi ne viral load yakho? {IsiZulu} [going back for a CD4 cell count and checking your viral load?] Has it laid you fears?

Thami Mthembu:Well, yeah ngoba bahlale basho ukuthi knowledge is power, I really think I mean, ngi fila ukuthi it put a lot of ama-concerns wami at ease. {IsiZulu} [yeah, as they say that knowledge is power, it has put a lot of my concerns at ease.] I’m actually looking forward to starting ARVs.

Shalom Ncala:Namhlanje sifunde ukuthi ukubhekhana nemiphumela imibi yinqcenye esemuxoka yokhuphuza amaARVs, uma ubanemiphumela emibi, thithana nodokotela noma umuhlengikazi wakho. Ungayeki ukuphuza amaARVs wakho ungakatholi imvume kubo. Ngoba lokhu kungayenza ukuthi umzimba wakho uwalane nawo phecelezi iresistance. Evikini sithola izincwadi eziningi ezivela kuni babukeli bethu. Sicela iqubeke ngosinibhalela nisitshela ukuthi nicabangani ngohlelo lwethu. Ninga Qhumana nathi kulemininigwane ekumabonakunde wenu manje. Sithemba ukuthi ulijabulele uhlelo lwethu futhi unomoya wo Siyayinqoba sisonke singayohlula. Hlangana nathi futhi evikini elizayo eqenjweni leSiyayinqoba Beat It! Kuze kube yileso sikhathi hlala unephilo futhi unethemba.Salani kahle. {IsiZulu} [Today we’ve learnt that dealing with side- effects is an important aspect of being on ARVs. If you experience side-effects, consults your doctor or nurse. Do not stop your ARVs on your own, as this can lead to resistance Each week, we receive many letters from you, our viewers. Please keep them rolling in and tell us what you think of our programme. You can contact us on the details on you screen now. We hope that you enjoyed the show are feeling the Siyayinqoba spirit, together we can Beat It! Join us again next week on the Siyayinqoba Beat It! support group. Until then, stay healthy, stay positive. Goodbye.]

< previous episode | next episode >