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Understanding AIDS/HIV -- Diagnosis & Treatment


What Is the Treatment for HIV/AIDS? continued...

Fortunately, many drugs are now available and can be used in combination to try to control the HIV.

Currently, HIV is treated with combination drug therapies, known as "cocktails." This way, when the virus figures out how to get around one drug, there's another drug in the body to block the virus from duplicating itself. Unfortunately, as the HIV epidemic has grown, there are now mutations of HIV that are resistant to many of the available drugs. HIV drugs don't have the same results for everyone. The good news is that HIV researchers are constantly discovering new drugs to block HIV at different points in its life cycle. Your doctor can determine what combination of new drugs might work for you.


Current HIV drugs work at various parts of the HIV replication cycle:

Entry and Fusion Inhibitors. Viruses depend on other cells to reproduce themselves. This is essential for HIV, because the virus only lives for a short period of time. HIV uses the CD4 T-cell by attaching to the T-cell and getting inside. One new class of HIV drugs, called entry inhibitors, keep HIV from entering the CD4 T-cell. 

Replication. HIV depends on the CD4 T-cells' DNA to reproduce itself, because the virus has no DNA of its own. To do this, HIV uses an enzyme called reverse transcriptase (RT) to change RNA into DNA. One class of drugs, called nucleoside reverse transcriptase inhibitors (NRTIs), fool HIV into making unusable DNA. There is also a class of drugs -- the non-nucleoside reverse transcriptase inhibitors (NNRTIs) -- that were designed to prevent the RNA from working at all.

People call these drugs "nukes" (nucleosides) and "non-nukes" (non-nucleosides) for short. There are now 10 NRTI drugs ("nukes") available and several NNRTI drugs ("non-nukes") available for people living with HIV/AIDS.

Integration. Integrase inhibitors are a type of drug that blocks the enzyme integrase, which HIV needs to infect CD4 cells with its genetic material.

Reassembly. Once HIV has invaded a T-cell's DNA and fooled it into making the pieces of HIV needed, the virus has to put the pieces together. This is done using an enzyme called protease. Drugs called protease inhibitors (PIs) prevent the virus from putting these new pieces together and creating new viral particles. There is now a variety of protease inhibitors available to help fight HIV/AIDS. These PIs are given credit for saving the lives of many people living with AIDS who are now recovering and returning to normal lives.

HIV/AIDS Drug Side Effects

These HIV drugs sometimes have side effects, especially when a person first starts to use them. Often, the side effects go away as the body adjusts to the medication:

  • Nausea and vomiting are common at the beginning of treatment.
  • Diarrhea needs to be managed if it lasts beyond three days.
  • A rash may be a sign of an allergic reaction and should always be reported to a doctor immediately. If it's not an allergy, a rash usually goes away by itself.
  • Sleep disturbances include trouble falling or staying asleep.
  • Pain, numbness, or tingling in the hands and feet need to be reported to a doctor.
  • Excess fat may appear as the body begins storing fat between the shoulders, in the breasts, or on the belly as a result of some medications. This is called lipodystrophy syndrome.
  • Kidney stones are common with Crixivan, one of the older protease inhibitors.
  • Cholesterol and blood sugar changes are possible and blood tests are required to monitor them. 

If you experience side effects from medications, note how often they occur and what time of day. This information may help your doctor determine how to best manage the side effects. Never stop taking your medications simply because they have side effects -- it  can give HIV a chance to mutate and grow more quickly. Working with your doctor to adjust medications is the best way to manage side effects.


WebMD Medical Reference

Reviewed by David T. Derrer, MD on March 30, 2014
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