|Generic Name||Brand Name|
|Generic Name||Brand Name|
|efavirenz, emtricitabine, tenofovir||Atripla|
|emtricitabine, rilpivirine, and tenofovir||Complera|
These medicines may be available in other combinations to
treat HIV infection.
How It Works
Nonnucleoside reverse transcriptase
inhibitors (NNRTIs) are antiretroviral medicines. They prevent the human
immunodeficiency virus (HIV) from multiplying. When the amount
of virus in the blood is kept at a minimum, the
immune system has a chance to recover and grow
Why It Is Used
The use of three or more
antiretroviral medicines (antiretroviral therapy, or ART) is the usual treatment for HIV infection.
combination of medicines used for ART will depend on your health, other
conditions you might have (such as
hepatitis), and results of testing. Talk to your
doctor about the best treatment plan for you.
Medical experts recommend that people begin treatment for HIV as soon as they know that they are infected.1, 2 Treatment is especially important for pregnant women, people who have other infections (such as tuberculosis or hepatitis), and people who have symptoms of AIDS.
You may also want to start HIV treatment if your sex partner does not have HIV. Treatment of your HIV infection can help prevent the spread of HIV to your sex partner.3
The U.S. National Institutes of Health recommends one of the following programs for people who start treatment for HIV:3
- Efavirenz + tenofovir + emtricitabine
- Ritonavir-boosted atazanavir + tenofovir + emtricitabine
- Ritonavir-boosted darunavir + tenofovir + emtricitabine
- Raltegravir + tenofovir + emtricitabine
- HIV: When Should I Start Antiretroviral Medicines for HIV Infection?
- HIV: Taking Antiretroviral Drugs
How Well It Works
When compared with people who are
given single- or double-medicine therapy, people who are given triple-medicine
- Have a greater reduction in viral
- Have better immune system recovery (measured by increased
CD4+ cell counts).
- Are less likely to develop
resistance to their medicines.
- Are likely
to live longer.
Antiretroviral therapy can also decrease symptoms of HIV
infection, such as fever, weakness, and weight loss.
The rate at
which antiretrovirals decrease viral loads is affected by:3
- CD4+ cell counts at the start of
- Viral load at the start of
- The dosage of the medicines.
medicines are taken exactly as prescribed.
- Whether antiretroviral
medicines have been taken before.
opportunistic infections are present.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call911or other emergency services right away if you have:
Call your doctor if you have:
Common side effects of these medicines include:
In rare cases, nevirapine causes liver damage that can
be severe and life-threatening. Regular blood tests may be needed to watch
for liver problems.
Etravirine can cause a rare, but severe, skin reaction.
Side effects of any combination medicine can include the
side effects of any of the single medicines in the combination.
Side effects usually are not as bad after your body has adjusted to the
medicine. Report all side effects to your doctor. He or she may be able to help
you reduce side effects by giving you other medicines.
Many people think that antiretroviral medicines always have
severe side effects. In fact, only a few people experience severe side
Reference for a full list of side effects. (Drug Reference is not available in
What To Think About
Resistance to single-medicine
NNRTI treatment develops quickly. For this reason, they should be used only in
combination with other antiretroviral medicines to treat HIV infection or to
prevent or delay the development of resistance.
Things to think about when choosing a combination of medicines
- The ability of the medicines to reduce your
- The likelihood that you will develop resistance to the
medicines. If you have already been treated with a certain antiretroviral
medicine, you may already know whether you are resistant to medicines in that
- Side effects and your willingness to tolerate
- The cost of treatment.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
U.S. Department of Health and
Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2012). Guidelines for the Use of Antiretroviral Agents
in HIV-1-Infected Adults and Adolescents. Available online: http://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf.
Thompson MA, et al. (2012). Antiretroviral treatment of adult HIV infection: 2012 recommendations of the International Antiviral Society—USA Panel. JAMA, 308(4): 387–402.
U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2011). Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Available online: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Peter Shalit, MD, PhD - Internal Medicine|
|Last Revised||November 7, 2012|