HIV/AIDS Drugs & Medications

Treatment Options

There is no cure for AIDS at this time. However, several treatments are available that can delay the progress of HIV and improve the quality of life of those who have developed symptoms.

Antiretroviral Therapy

Antiretroviral drugs inhibit the growth and replication of HIV at various stages of its life cycle.

Nucleotide Analog Reverse Transcriptase Inhibitors

Viread (tenofovir disoproxil fumarate) is the first nucleotide analog reverse transcriptase inhibitor approved for HIV treatment. It works by blocking an enzyme (reverse transcriptase) crucial to the production and replication of HIV.

Nucleotide analogs are different from the nucleoside analogs, although they act in much the same way. In order for nucleoside analogs to work, they must undergo chemical changes (phosphorylation) to become active in the body. Nucleotide analogs bypass this step, given that they are already chemically activated.

Lowering the amount of HIV in the blood may in turn increase the CD4 count. This helps improve the immune system, increasing its ability to defend the body against HIV infection.

Brand Name Generic Name Abbreviation
Viread tenofovir disoproxil fumarate (DF) TDF or Bis(POC) PMPA

Nucleoside Analog Reverse Transcriptase Inhibitors (NRTIs)

Brand Name Generic Name Abbreviation
Retrovir zidovudine AZT or ZDV
Epivir lamivudine 3TC
Ziagen abacavir ABC
Hivid zalcitabine ddC
Videx didanosine ddI
Zerit stavudine d4TT
Combivir zidovudine + lamivudine AZT + 3TC
Trizivir abacavir + zidovudine + lamivudine ABC + AZT + 3TC

NRTIs, sometimes referred to as Nucleoside Analogs or "nukes", were the first antiretroviral drugs to be developed. They work by blocking an enzyme (reverse transcriptase) crucial to the production and replication of HIV.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Brand Name Generic Name Abbreviation
Viramune nevirapine NVP
Rescriptor delavirdine DLV
Sustiva efavirenz EFV

NNRTIs, sometimes referred to as Non-Nucleoside Analogs or "non-nukes", bind directly to the enzyme (reverse transcriptase). They work by preventing the enzyme from converting RNA to DNA, which means that the genetic material of the HIV virus cannot be incorporated into the healthy genetic material of the cell, thereby preventing the cell from producing a new virus.

Protease inhibitors (PIs)

Generic Name Brand Name Abbreviation
Invirase saquinavir SQV (HGC)
Fortovase saquinavir SQV (SGC)
Norvir ritonavir RTV
Crixivan indinavir IDV
Viracept nelfinavir NFV
Agenerase amprenavir APV
Kaletra lopinavir + ritonavir LPV

Protease Inhibitors (PIs) work by interfering with the enzyme HIV protease, which in turn interrupts HIV replication at a later stage in its life cycle. This causes HIV particles in the body to become structurally disorganized and noninfectious.

PIs can cause a significant number of side effects when they interact with certain other medications metabolized by a particular enzyme system in the liver.

Highly Active Anti-Retroviral Therapy (HAART)

A combination of three or more antiretroviral agents, called Triple Therapy or Highly Active Anti-Retroviral Therapy (HAART), has been highly effective in reducing the number of HIV particles in the blood stream (as measured by a blood test called the viral load test) and as a result increasing the CD4 count.

The aim of treatment is to achieve maximum suppression of symptoms for as long as possible. Treatment guidelines also emphasize the importance of quality of life, so the goal is to find the strongest possible regimen that is also simple and has the fewest side effects..

HAART is not a cure for HIV and the HIV virus can still be transmitted to others. However the treatment gives promising results. There is evidence that prolongation of life can be achieved by suppressing HIV levels and maintaining high CD4 counts (>200/ml). The disadvantages are resistance to the drugs in patients who do not take the medications every day and the ability of certain strains of HIV to mutate easily and become resistant to HAART

New Treatments

More than a dozen HIV vaccines are currently being tested, and many new drugs for HIV- or AIDS-related infections are in development. Although these drugs are not yet licensed, some may be available by compassionate exception to people who need them.

For more information on new therapies, call the AIDS Clinical Trials Information Service at 800-TRIALS-A. If you'd like to find out more about federally approved treatment guidelines, contact the HIV/AIDS Treatment Information Service at 800-HIV-0440.

See Also:

Last updated: 2013-08-27 by L. Anderson, PharmD

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