Human Immunodeficiency Virus (HIV) Infection - Medications
Medicines are the primary treatment for
HIV. Your doctor will usually prescribe several
medicines-this is sometimes called an anti-HIV "cocktail"-that keeps HIV from
multiplying and helps keep the
immune system healthy. In the past a person had to
take several doses of HIV medicine every day, which was hard for some
people. But over the past few years, this routine has become much simpler. And
people take their medicine for HIV only once or twice a day.
Medicines used to treat HIV are called antiretrovirals, and several of
these are combined for treatment called
highly active antiretroviral therapy, or HAART. Using
HAART reduces your risk of developing
resistance to HIV medicines.
When choosing antiretroviral medicines, your doctor will
think about certain things, such as:
- The medicines' effectiveness in reducing
- The likelihood that the virus
resistant to a certain class of medicine. If you have
already been treated with a certain antiretroviral medicine, you or your doctor
may already know whether you have a resistance to medicines in that
- Medicine side effects and your willingness to tolerate
- The cost of treatment with medicines.
Medicines also are used to
prevent other illnesses that can occur with HIV as the
result of a
weakened immune system. Certain
opportunistic infections, such as some types of
pneumonia, can develop when HIV attacks and destroys
CD4+ cells. If too many CD4+ cells are destroyed, the
body can no longer fight off infection.
Medicines that prevent
HIV from multiplying are called antiretrovirals and include:
- Nucleoside/nucleotide reverse transcriptase inhibitors, such as tenofovir, emtricitabine, and abacavir.
- Nonnucleoside reverse transcriptase inhibitors (NNRTIs), such as efavirenz, nevirapine, or
- Protease inhibitors (PIs), such as atazanavir,
ritonavir, or darunavir.
- Fusion and entry inhibitors, such as enfuvirtide and maraviroc.
- Integrase inhibitors. The only integrase inhibitor
approved by the U.S. Food and Drug Administration (FDA) for HIV treatment is
- HIV: When Should I Start Taking Antiretroviral Medicines for HIV Infection?
- HIV: Taking Antiretroviral Drugs
The U.S. National Institutes of Health recommends one of the following programs for people who begin treatment for HIV:5
- Efavirenz + tenofovir + emtricitabine
- Ritonavir-boosted atazanavir + tenofovir + emtricitabine
- Ritonavir-boosted darunavir + tenofovir + emtricitabine
- Raltegravir + tenofovir + emtricitabine
If your viral load does not
drop as expected, or if your CD4+ cell count starts to fall, your doctor will
try to determine why the treatment was not effective.
two main reasons that treatment fails:
- The virus that causes HIV has become
resistant. The medicine no longer effectively controls virus multiplication nor
protects your immune system. Tests can show whether resistance has
occurred. You may need a different combination of medicines.
- You did not take your medicine as prescribed. If you have
difficulty taking the medicines exactly as prescribed, talk with your
What to think about