This is the main treatment for HIV or AIDS. It is not a cure, but it can stop people from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of a person’s life.
The aim of antiretroviral treatment is to keep HIV at a low level. This halts weakening of the immune system and allows it to recover from any damage that HIV might have caused.
The drugs are often referred to as:
Taking two or more antiretroviral drugs at a time is called combination therapy. Taking a combination of three or more anti-HIV drugs is sometimes referred to as Highly Active Antiretroviral Therapy (HAART).
If only one drug was taken, HIV would quickly become resistant to it and the drug would stop working. Taking two or more antiretrovirals at the same time vastly reduces the rate at which resistance would develop, making treatment more effective in the long term.
There are more than 20 approved antiretroviral drugs but not all are licensed or available in every country.
There are five groups of antiretroviral drugs. Each of these groups attacks HIV in a different way.
| Antiretroviral drug class | Abbreviations | First approved to treat HIV | How they attack HIV |
|---|---|---|---|
| Nucleoside/Nucleotide Reverse Transcriptase Inhibitors | NRTIs, nucleoside analogues, nukes | 1987 | NRTIs interfere with the action of an HIV protein called reverse transcriptase, which the virus needs to make new copies of itself. |
| Non-Nucleoside Reverse Transcriptase Inhibitors | NNRTIs, non- nucleosides, non- nukes | 1997 | NNRTIs also stop HIV from replicating within cells by inhibiting the reverse transcriptase protein. |
| Protease Inhibitors | PIs | 1995 | PIs inhibit protease, which is another protein involved in the HIV replication process. |
| Fusion or Entry Inhibitors | 2003 | Fusion or entry inhibitors prevent HIV from binding to or entering human immune cells. | |
| Integrase Inhibitors | 2007 | Integrase inhibitors interfere with the integrase enzyme, which HIV needs to insert its genetic material into human cells. |
NRTIs and NNRTIs are available in most countries. Fusion/entry inhibitors and integrase inhibitors are usually only available in resource- rich countries.
Protease inhibitors are generally less suitable for starting treatment in resource-limited settings due to the cost, number of pills which need to be taken and the particular side effects caused by protease drugs.
