The first drug to treat and manage HIV infection and AIDS was approved in 1987, and today, more than 20 antiretroviral, or anti-HIV, drugs are available, according to 2009 information from the U.S. Food and Drug Administration. However, it is important to note that there is no cure for AIDS. Drug treatments help reduce the levels of the HIV virus in the blood, keep the immune system as healthy as possible and decrease the complications that may develop.
Nucleotide Reverse Transcriptase Inhibitors (NRTIs)
NRTIs are the first class of anti-HIV medications that were approved by the FDA and include drugs such as abacavir, lamivudine and zidovudine. According to MayoClinic.com, these drugs are faulty replicas of the components of the HIV that interfere with the process of HIV multiplication, thereby preventing the spread of the virus. Common side effects include nausea, vomiting, fever and rash.
Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
NNRTIs prevent the infection of new human immune cells by HIV and are prescribed in combination with other anti-HIV drugs. This class includes drugs such as delavirdine, efravirenz, and nevirapine, and skin rash is the most common side effect.
Protease Inhibitors (PIs)
Protease Inhibitors block the activity of a viral enzyme known as protease thereby, preventing the process of viral multiplication. This class includes drugs such as amprenavir, fosamprenavir, indinavir, and lopinavir. The University of California San Francisco Medical Center recommends that any side effects should be discussed with the physician because the side effects from protease inhibitors vary, depending on the individual.
Integrase Inhibitors (INSTIs)
An important step in the life cycle of HIV, is when the virus inserts its genetic material into human cells, and according to MayoClinic.com, integrase inhibititors work by blocking this step. Raltegravir is a drug that belongs to this class of medications, and according to an article published in July 2008 edition of "The New England Journal of Medicine," raltegravir in combination with other anti-HIV drugs provides better suppression of the virus than other drugs for at least 48 weeks. Insomnia, nausea, fatigue and headache are the common side effects.
Fusion Inhibitors
Fusion inhibitors include drugs such as enfuvirtide and maraviroc, and these drugs act by blocking the entry of HIV into the immune cells. These drugs are available in tablet and injection forms and common side effects include constipation, dizziness, redness and pain at the site of injection, loss of appetite and weakness.
Highly Active Antiretroviral Therapy
The HIV virus has the ability to develop resistance very quickly, especially if only one antiretroviral drug is used. To overcome this problem, HAART was developed in 1996. HAART is a combination of three or more drugs that are given to the patient at the same time. According to the guidelines issued by the U.S. Department of Health, the initial antiretroviral therapy should include one of three regimens: one NNRTI plus two NRTIs, one PI plus two NRTIs, or one INSTI plus two NRTIs. However, based on individual patient characteristics and needs, an alternative regimen may actually be a preferred regimen for a patient.
References
- MayoClinic.com: HIV/AIDS
- UCSF Medical Center: HIV/AIDS
- "The New England Journal Of Medicine"; Raltegravir with Optimized Background Therapy for Resistant HIV-1 Infection; Roy T. Steigbige et al; July 2004
- National Institutes of Health: Guidelines for the Use of Antiretroviral
- U.S. Food and Drug Administration: Timeline/History
