Antiretrovirals: HIV and AIDS Drugs

HIV medications can help lower your viral load, fight infections, and improve your quality of life. But even if you take them, you can still give HIV to others. They're not a cure for HIV.

The goals for these medicines are to:

  • Control the growth of the virus
  • Improve how well your immune system works
  • Slow or stop symptoms
  • Cause as few side effects as possible

The FDA has approved more than two dozen antiretroviral drugs to treat HIV infection. They're often broken into six groups because they work in different ways. Doctors recommend taking a combination or "cocktail" of at least two of them. This is called antiretroviral therapy, or ART.

Your doctor will let you know specifically how you should take your medications. You need to follow the directions exactly, and you shouldn't miss even one dose. Or you could develop drug-resistant strains of HIV, and your medication may stop working.

Some other medicines and supplements don't mix well with HIV drugs, so make sure you tell your doctor about everything you're taking.

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

NRTIs force the HIV virus to use faulty versions of building blocks so infected cells can't make more HIV.

Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

These are also called "non-nukes." NNRTIs bind to a specific protein so the HIV virus can't make copies of itself, similar to jamming a zipper.

Protease Inhibitors (PIs)

These drugs block a protein that infected cells need to put together new copies of the HIV virus.

Cobicistat (Tybost) is a drug that helps atazanavir and darunavir work better, but it can cause life-threatening kidney problems if you take it with certain other medicines.

  • Atazanavir + cobicistat, or ATV/COBI (Evotaz)
  • Darunavir + cobicistat, or DRV/COBI (Prezcobix)

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Fusion Inhibitors

Unlike NRTIs, NNRTIs, and PIs -- which work on infected cells -- these drugs help block HIV from getting inside healthy cells in the first place.

Enfuvirtide, or ENF or T-20 (Fuzeon), has been approved by the FDA. Fostemsavir, ibalizumab, PRO 140, and others are being tested for approval.

CCR5 Antagonist

Maraviroc, or MVC (Selzentry), also stops HIV before it gets inside a healthy cell, but in a different way than fusion inhibitors. It blocks a specific kind of "hook" on the outside of certain cells so the virus can't plug in.

Integrase Inhibitors

These stop HIV from making copies of itself by blocking a key protein that allows the virus to put its DNA into the healthy cell's DNA. They're also called integrase strand transfer inhibitors (INSTIs).

Fixed-Dose Combinations

Some drug manufacturers put together specific medicines into a single pill so they're easier to take, including:

  • Abacavir + dolutegravir + lamivudine, or ABC/DTG/3TC (Triumeq)
  • Abacavir + lamivudine, or ABC/3TC (Epzicom)
  • Abacavir + lamivudine + zidovudine, or ABC/3TC/ZDV (Trizivir)
  • Efavirenz + emtricitabine + tenofovir, or EFV/FTC/TDF (Atripla, Tribuss)
  • Elvitegravir + cobicistat + emtricitabine + tenofovir, or EVG/COBI/FTC/TAF or ECF/TAF (Genvoya)
  • Elvitegravir + cobicistat + emtricitabine + tenofovir, or EVG/COBI/FTC/TDF or ECF/TDF (Stribild)
  • Emtricitabine + rilpivirine + tenofovir, or FTC/RPV/TAF (Odefsey)
  • Emtricitabine + rilpivirine + tenofovir, or FTC/RPV/TDF (Complera)
  • Emtricitabine + tenofovir, or TAF/FTC (Descovy)
  • Emtricitabine + tenofovir, or TDF/FTC (Truvada)
  • Lamivudine + zidovudine, or 3TC/ZDV (Combivir)

Truvada has also been approved as a way to prevent HIV infection for people who are at high risk. Even if you take it, you have to practice safe sex, too.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on November 11, 2016

Sources

SOURCES:

UpToDate: "Overview of antiretroviral agents used to treat HIV."

AIDSinfo Drug Database.

NIAID: "Treatment of HIV Infection."

American Academy of Family Physicians: "How to Take Your Medicines for HIV," "Medicines for People Who Are HIV Positive."

U.S. Dept. of Health and Human Services: "HIV and Its Treatment: What You Should Know," "Approved Medications to Treat HIV Infection."

Hammerl. JAMA, Aug. 16, 2006.

New Mexico AIDS Education and Training Center: "Taking Current Antiretroviral Drugs," "Other Antiretroviral Drugs in Development," "Immune Therapies in Development.

FDA: "First of a Kind in HIV Treatment."

AIDSinfo: "Fusion Inhibitor," "CCR5 Antagonist."

AIDS Treatment Data Network: "Drugs Used to Treat HIV."

Johns Hopkins Medicine: "Antiretroviral Therapy: Initial Regimen."

AIDS.gov: "Pre-Exposure Prophylaxis (PrEP)."

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