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Treatment for HIV/AIDS

Information on Antiretroviral Medication

May 21, 2008 Kris Lee Wai Loon

Although there is still no cure for HIV/AIDS, various antiretroviral drugs have been developed to inhibit the replication of the virus in the human immune system.

Presently, researchers have not been able to produce a vaccine against infection by the Human Immunodeficiency Virus (HIV), nor a cure for HIV infection and Acquired Immune Deficiency Syndrome (AIDS). Without treatment, an HIV+ person will develop AIDS within 10 – 15 years after infection.

Nevertheless, being HIV+ is no longer a death sentence. With the rapid progress in medical sciences and the availability of more treatment options, the prognosis for HIV infection has become increasingly positive.

Newer antiretroviral (ARV) medications are able to not only retard the development of the HIV infection (speed of replication of the virus), but also suppress the effects of the virus itself. In the process, the patient’s immune system can be slowly restored such that he/she can continue to lead a normal and illness-free life. Consequently, HIV/AIDS has become more of a treatable chronic condition, although complete recovery is still not possible.

ARV Medications

Often referred to as antiretrovirals, anti-HIV drugs or HIV antiviral drugs, ARV medications comprise five main groups, each serving a different function.

1. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTI)

NRTIs are also known as nucleoside analogues or nukes, and include medications such as zidovudine (Retrovir), tenofovir DF (Viread), and stavudine (Zerit).

Approved for use since 1987, these are the first type of drugs used to treat HIV infection. These drugs bind to an HIV protein called reverse transcriptase (RT), thereby blocking its action. Since the protein can no longer function effectively as the building block, the virus is unable to replicate.

2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)

NNRTIs (also known as non-nucleosides or non-nukes) were first approved for use in 1997. These include medications such as nevirappine (Viramune) and efavirenz (Sustiva).

Unlike NRTIs, NNRTIs “pretend” to be the HIV RT protein. However, NNRTIs are actually faulty versions of that protein. When the virus makes use of an NNRTI instead of the actual RT protein, replication of the virus becomes stalled.

3. Protease Inhibitors (PI)

The first PI was approved for use in 1995, and includes medications such as lopinavir and ritonavir (Kaletra).

Protease is another protein that HIV needs in order to replicate. PIs act by blocking the functioning of this protein.

4. Fusion or Entry Inhibitors (FI)

FIs are a newer form of treatment that works by directly blocking the entry of HIV into human immune cells.

Enfuvirtide (Fuzeon) is one type of FI medication. Another FI is commonly known as T-20, which has been licensed in the United States and Europe since 2003. Unlike the other ARV medications which are orally ingested, T-20 has to be injected. It is restricted for use by patients who have tried but did not respond to other ARV medications.

A third FI, called maraviroc or CCR5 inhibitor, is the newest drug in this group. Licensed in 2007, this drug acts by blocking the CCR5 co-receptor of the human immune cells, thereby preventing HIV from attaching itself to the cell’s surface and subsequently infecting it.

5. Integrase Inhibitors (II)

Integrase is an enzyme which HIV needs in order to insert its genetic material into the human immune cells. IIs work by blocking the effectiveness of that enzyme.

So far, this group only has one drug: raltegravir. It was approved for use in the United States in October 2007 and was introduced to the United Kingdom in January 2008.

A complete list of approved ARV medications can be found here. To be effective, more than one ARV drug is usually used in combination therapy.

The copyright of the article Treatment for HIV/AIDS in General Medicine is owned by Kris Lee Wai Loon. Permission to republish Treatment for HIV/AIDS in print or online must be granted by the author in writing.

Pills and Medication.