HIV Treatment & Drug Classes

If you take or have taken 1 or more treatment regimens to treat HIV, you are probably familiar with many of the antiretroviral (ARV) medications available today. You also may know that treatment can be complicated, especially if you have become resistant to a medication.
Make sure you are familiar with the different classes of medications that treat HIV, so that you can have an informed conversation with your doctor about finding a treatment that works, and will keep working, for you. Explore the links below for an overview of ARV medications and drug classes.

HIV Treatment Goals

HIV medications, or antiretroviral (ARV) medications, which are used to treat the HIV virus, cannot cure the disease, but they may keep the virus from reproducing or making copies of itself.
HIV medication has 4 major goals:
1. Extend life expectancy and quality of life
2. Prevent HIV from progressing
Reduce the viral load (the amount of HIV virus in the blood) to undetectable levels (less than50 copies/milliliter) for as long as possible
Limit the development of resistance (when the virus no longer responds) to ARV medications
3. Restore and preserve the immune system to normal
Keep CD4 cell counts in the normal range or raise CD4 counts if they are too low
Resist other infections
4. Reduce transmission of HIV to others.
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Drug Classes

Four classes of HIV medications fight against HIV. Each class is defined by how it attacks the virus.

Class
Nucleoside reverse transcriptase inhibitors (NRTIs), also known as "nukes", nucleoside analogs, or backbone
1. Abacavir (ABC)
2. Abacavir + Lamivudine (ABC + 3TC)
3. Abacavir + Lamivudine + Zidovudine (ABC + AZT + 3TC)
4. Didanosine (ddl)
5. Emtricitabine (FTC)
6. Tenofovir DF + Emtricitabine (TDF + FTC)
7. Lamivudine (3TC)
8. Stavudine (d4T)
9. Tenofovir DF (TDF or Bis(POC) PMPA)
10. Zalcitabine (ddC)
11. Zidovudine (AZT or ZDV)
12. Zidovudine + Lamivudine (AZT + 3TC)

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
1. Efavirenz (EFV)
2. Nevirapine (NVP)

Protease inhibitors (PIs)
1. Atazanavir (ATZ)
2. Darunavir (DRV)
3. Fosamprenavir (FPV)
4. Indinavir (IDV)
5. Lopinavir + Ritonavir (LPV)
6. Nelfinavir (NFV)
7. Ritonavir (RTV)
8. Saquinavir (SQV)
9. Tipranavir (TPV)

Fusion inhibitors (FIs)
Enfuvirtide (T-20)
The newest class of available ARV medications, FIs block HIV from entering the body's healthy cells. This medication must be administered by injection.
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Combination Therapy
Therapy for HIV usually includes 3 or more HIV medications from the classes outlined above. The combination of these HIV medications is designed to keep the virus from making copies of itself, while minimizing potential side effects and pill burden. These combinations are referred to as HAART, highly active antiretroviral therapy.
The International AIDS Society lists the following potential initial combination regimens for the treatment of HIV:
2 NRTIs + 1 PI with or without ritonavir (for boosting)
2 NRTIs + 1 NNRTI
Factors such as adherence, drug resistance, and side effects may cause a HAART regimen to fail. If this happens, your doctor will make a decision about how to change your medication regimen based partly on your treatment history, how many medication combinations you have tried, and whether you have become resistant to an antiretroviral (ARV) medication.