HIV medications can help lower your viral load, fight infections, and improve your quality of life. They can lower your chances of transmitting HIV, but if you take them incorrectly, 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
- Prevent transmission of HIV to others
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. If you miss doses, 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 HIV virus particles.
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).
Unlike NRTIs, NNRTIs, PIs, and INSTIs -- which work on infected cells -- these drugs help block HIV from getting inside healthy cells in the first place.
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.
Post-Attachment Inhibitor or Monoclonal Antibody
This is a new class of antiviral medication specifically for adults living with HIV who have tried multiple HIV medications and whose HIV has been resistant to current available therapies. Ibalizumab-uiyk (Trogarzo) blocks your body’s HIV infected cells from spreading the virus into those which are uninfected. It is administered by IV.
Cobicistat (Tybost) is a drug that helps some drugs (atazanavir, darunavir, elvitegravir) work better, but it can increase the levels of other medicines you may be taking (always tell your doctor about these other medicines).
Some drug manufacturers put together specific medicines into a single pill so they're easier to take, including:
Integrase strand transfer inhibitor (INSTI)-based:
- Bictegravir + tenofovir alafenamide + emtricitabine, or BIC/TAF/FTC (Biktarvy)
- Dolutegravir + abacavir + lamivudine, or DTG/ABC/3TC (Triumeq)
- Dolutegravir + rilpivirine, or DTG/RPV (Juluca)
- Dolutegravir + lamivudine, or DTG/3TC (Dovato)
- Elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine or EVG/c/TAF/FTC (Genvoya)
- Elvitegravir + cobicistat + tenofovir disoproxil fumarate + emtricitabine, or EVG/c/TDF/FTC (Stribild)
Protease inhibitor (PI)-based:
Non-nucleoside reverse transcriptase inhibitor (NNRTI)-based:
- Doravirine + tenofovir disoproxil fumarate + lamivudine, or DOR/TDF/3TC (Delstrigo)
- Efavirenz + tenofovir disoproxil fumarate + emtricitabine, or EFV/TDF/FTC (Atripla)
- Rilpivirine + tenofovir alafenamide + emtricitabine , or RPV/TAF/FTC (Odefsey)
- Rilpivirine + tenofovir disoproxil fumarate + emtricitabine or RPV/TDF/FTC (Complera)
Nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-based:
- Abacavir + lamivudine, or ABC/3TC (Epzicom)
- Abacavir + lamivudine + zidovudine, or ABC/3TC/ZDV (Trizivir)
- Tenofovir alafenamide + emtricitabine, or TAF/FTC (Descovy)
- Tenofovir disoproxil fumarate + emtricitabine, or TDF/FTC (Truvada)
- Tenofovir disoproxil fumarate + lamivudine, or TDF/3TC (Cimduo)
- Zidovudine + Lamivudine or ZDV/3TC (Combivir)
Truvada has also been approved as a way to prevent HIV infection for people who are at high risk. But if you take it, you have to practice safe sex, too.