Headache Treatment in Human Immunodeficiency Virus Infection

Abstract

Abstract This chapter describes headache treatment in human immunodeficiency virus (HIV) infection. Antivirals used in HIV-infected patients can lead to headaches. The virus can cause headaches itself, perhaps on the basis of active central nervous system infection or due to the fact that the metabolism of serotonin and tryptophan seems to be altered in HIV infection. However, primary headaches in patients with HIV infection are very common and usually not related to the antiretroviral drug therapy. In general, beta-blockers, tricyclic antidepressants, topiramate, and perhaps calcium channel blockers can make good choices in patients with HIV naïve to headache prophylactic treatment, but there are risks. One should carefully consider medication interactions as well as comorbidities when choosing the most appropriate acute and preventive medications in HIV patients on antiretroviral medications.