Drugs for HIV Infection and AIDS

A range of drugs that are used to treat HIV infection and its complications

Common drugs

    Reverse transcriptase inhibitors

  • Abacavir

  • Didanosine

  • Efavirenz

  • Emtricitabine

  • Etravirine

  • Lamivudine

  • Nevirapine

  • Stavudine

  • Tenofovir

  • Zidovudine

    Protease inhibitors

  • Atazanavir

  • Darunavir

  • Fosamprenavir

  • Indinavir

  • Ritonavir

  • Saquinavir

  • Tipranavir

    Fusion inhibitors

  • Enfuvirtide

    Other anti-HIV/AIDS drugs

  • Maraviroc

  • Raltegravir

For people with HIV infection and AIDS continued advances in drug treatments that slow or halt the progression of the disease have enabled most people to stay healthier for longer and to live comparatively normal lives. However, drug treatments cannot cure the disease and a vaccine to protect against infection is still in the experimental stage.

The human immunodeficiency virus (HIV) infects and gradually destroys white blood cells of the body’s immune system, known as CD4 lymphocytes, which normally help to fight infections. People with HIV infection may remain symptom-free for many years, or they may experience frequent or prolonged mild infections. If a specific infection or tumour occurs, a person is said to have developed AIDS (acquired immunodeficiency syndrome). These conditions, called AIDS-defining illnesses, include a number of severe infections, such as pneumocystis infection, toxoplasmosis, and certain cancers, such as Kaposi’s sarcoma and non-Hodgkin’s lymphoma.

Why are they used?

The drugs currently in use to treat HIV infection have made it possible to suppress the level of the virus in the blood, with the aim of reducing it so that the virus becomes undetectable. If this aim is achieved, the immune system can recover sufficiently to deal with infections. The drugs may also be able to prevent the progression of HIV infection to AIDS. Evidence to support this is very encouraging, and many people who use the newer drugs have shown a dramatic improvement in their condition.

Treatment of HIV infection involves combinations of antiretroviral drugs, which act against the virus itself, and anti-infective drugs such as antibiotics, which are used to treat the diseases that develop as a result of reduced immunity.

Treatment with antiretroviral drugs is believed to be beneficial for anybody with HIV infection or AIDS, but expert opinion is still divided about the best time to begin this treatment. It is generally believed that the earlier treatment begins, the greater the possibility of altering the course of the disease. However, the benefits of early drug treatment have to be weighed against the potential long-term toxicity of the antiviral drugs for each individual.

People who have been in contact with blood or other body fluids from a person with HIV are given immediate treatment with antiretroviral drugs for 1 month. Antiretrovirals are also recommended for HIV-positive mothers during pregnancy to reduce the risk of the baby being born with the virus.

How do they work?

There are two main groups of antiretroviral drugs used in the treatment of HIV infection and AIDS: reverse transcriptase inhibitors and protease inhibitors. The drugs work by blocking the processes necessary for viral replication without significantly damaging the body cells that the virus has invaded. Reverse transcriptase inhibitors, such as zidovudine, inhibit viral enzymes involved in replication. Protease inhibitors, such as atazanavir, prevent the production of viral proteins necessary for replication. Fusion inhibitors and maraviroc inhibit the entry of HIV into body cells. Raltegravir works by preventing HIV from integrating its genetic material into the chromosomes of human cells, thereby preventing viral replication inside cells.

How are they used?

Treatment of HIV infection and AIDS is subject to rapid change as knowledge about the virus increases. Currently, antiretroviral drugs are generally used in combination to destroy the virus more effectively and help to prevent the development of drug-resistant strains of HIV. Most people are treated with a combination of three antiviral drugs, and the development of combined preparations with two or more drugs in a single pill has simplified treatment for many people.

What are the side effects?

If you have HIV infection, your doctor will discuss your treatment options with you at length because the drugs have side effects that should be weighed against the benefits of treatment.

Antiretroviral drugs can cause nausea, vomiting, and diarrhoea, which may be very severe. Other serious side effects include inflammation of the pancreas (see Acute pancreatitis) and damage to the nerves, liver, or kidneys. There may also be redistribution of body fat, and anaemia may develop. You need regular checkups and blood tests to look for warning signs of side effects. Pregnant women need expert advice on having treatment with antiretrovirals; these drugs may prevent transmission of HIV to the fetus but the effects of most antiretrovirals on fetal development are not known.



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