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The Use of Antiretrovirals

Antiretrovirals are the class of drugs used to treat HIV and AIDS. Though there is no cure for these conditions, the use of antiretroviral drugs can prolong health and prevent worsening symptoms for several years.

  1. Types of Antiretroviral Drugs

    • Antiretroviral drugs come in five varieties. Each one works in a unique way to attack the HIV in a person's body. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTI) work to block HIV by interfering with an HIV protein; the virus needs this protein in order to replicate itself in the body. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) also perform this function. Protease Inhibitors (PI) inhibit the protein Protease, which again helps with HIV replication. Fusion or Entry Inhibitors function by preventing HIV from binding to or entering human immune cells. Integrase Inhibitors also prevent HIV from inserting its genetic material into human cells.

    Treatment Options

    • Most people will have to take antiretroviral drugs daily for the rest of their lives for them to be effective in managing HIV symptoms. The purpose of the drugs is to keep the HIV levels in a person's body as low as possible. The benefits are twofold: First, the effects stop the immune system from weakening any further; and second, it helps to repair any damage that the HIV has already caused in the immune system to begin with.

      Most doctors prescribe combination therapy in the use of antiretroviral drugs. Combination therapy just means that the patient will take two antiretroviral drugs at one time. The strategy behind this is to combat any drug resistance. If a patient takes only one type of drug, the HIV may become resistant to it and resume its progress. Taking more than one drug helps to "outsmart" the HIV and continue the attack on the virus over a longer period of time before the HIV develops any resistance to the drugs.

      Some patients may take three or more antiretroviral drugs at one time. This is known as Highly Active Antiretroviral Therapy (HAART).

    Treatment Progression

    • Eventually the HIV will develop resistance to the drugs. In order to solve this problem, a multi-tiered approach to drug therapy and treatment for HIV is instituted.

      In the first line of therapy, the patient begins his dosage of antiretrovirals. Usually this would consist of a combination of two drugs from the NRTI category along with one from the NNRTI group. When a patient's HIV develops resistance to this treatment and symptoms worsen, what is referred to as the second line of therapy begins.

      During the second line of therapy, doctors will prescribe entirely new drugs from different categories. This will provide the variety needed to continue to battle the HIV without redundancy. This rotation of drug varieties will continue as the HIV becomes resistant to each new line of the drug regimen.

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