Q and A


What is the best ART?

I want to know which is the best ART and the side effect that comes with art treatment?


Hi, how are you?

All ART is effective. As long as you do not have resistance to drugs in the combination you are using ART will be effective at treating HIV.

There is no one best combination. There are newer combinations that have less side effects e.g., TLD is replacing TLE as first line as the side effects are more tolerable and is just as effective in suppressing HIV.

As there are so many combinations available it is not possible to list all along with their side effects. Have you had any mentioned to you? Different countries will use different treatments based on their own policy and availability.



  1. Josh Peasegood

    Hi Emmanuel, it is good that you are awaiting a second test to confirm the status of your kidneys. What is this ulcer that you have mentioned?

  2. Emmanuel

    Thanks J

    I had protein test in December and +1 was found in my urine. I am yet to do it again this January to reconfirm the status. If it has cleared considering the pain have reduced. I had discussed with my doctor but Stil making reference to ulcer which I am not comfortable with.

  3. Josh Peasegood

    Hi Emmanuel, it is good to hear that the pain is less. Have you had any discussions with your doctor yet about these symptoms? Your options need to be discussed with your doctor as it depends what treatments are available in the country that you are residing. Have you had any of the tests mentioned in our previous comments?

  4. Emmnauel

    I am in Nigeria, I am still taking the TLD. But I seriously need to no my options so I don’t continue harming my kidneys if it is the drug that is doing it. Of late the pains have reduced just the foamy urine when I urinate. Thanks for your help and I will really appreciate to no my effective options.

  5. Simon Collins

    Hi Emmanuel, I am covering this service for the next few weeks while Josh is on leave. Where are you living and what does your doctor say about this. This is because some countries have a much wider range of treatment options than others.

    Also, as clarification to your previous comment, the main drug that is linked to kidney function is tenofovir disoproxil. This is the ‘T’ in both TLE and TLD.

    What does your doctor say about this? Please contact them if you haven’t told them about this yet. Your kidneys are in your lower back and your doctor needs to know about any pain in your body.

    Several different tests are used to monitor kidney function, including testing for protein levels (proteinuria) and GLF (glomerular filtration rate).Results of these test will be used to decide if you need to change treatment, but this would usually involve just changing the type of tenofovir you are using.

    It is important to continue taking your full combination and definitely do not change to just use tenofovir.

  6. Emmanuel

    Thank you Josh,
    I won’t say it is monitored but I started having abdominal pain continuously since July which made me do kidney function test and scans but they said it is okay. Buy this pains are at my 2 sides which I presume the kidneys are located.

    Recently I did a urine analysis test which turned out that I have +1 protein in my Urine because it has been formy for like a month now. Is it okay to continue taking TLD or should I switch to Tenofovir and hope it will be as effective in keeping my VL undectectable

  7. Josh Peasegood

    Hi Emmanuel, is your kidney function being monitored while you are on TLD? As long as your kidney function is being monitored and there is no delicine in function it is safe to continue with TLD. Lower doses of TLD can also be used (tenofovir) if your eGFR is at lower levels of functional.

  8. Emmanuel

    Thanks a lot for the information, I was on TLE and was move to TLD when it replaced it as the first line of treatment. My viral load is zero (undetectable) and but I have always had abdominal pains which of late is translating to kidney related issue. I have +1 level of protein in my urine and sometimes slight pain by my 2 sides. Is it still ideal to continue on the TLD considering my kidney related issues or is there any other ART combination that will be “kidney friendly”


Your email address will not be published. Required fields are marked *