Different Types of HIV/AIDS Medications and Side Effects
Thirty-five years ago, a diagnosis of HIV/AIDS was pretty much a death sentence. The virus and its ravaging impact on the body was so new and mysterious that the medical community could do little more than provide patients with compassionate end-of-life care.
Thanks to research into new treatments and medications, diagnosis stories are being written much differently today. The chapters are longer, the narratives are full of hope, and there are no victims — there are survivors.
Treatment options are varied; their side-effects well documented.
What are antiviral drugs?
The main treatment for HIV is a class of drugs called antiretrovirals. These drugs don’t cure HIV, but they can reduce the amount of the virus in the body of someone with HIV. This keeps the immune system strong enough to fight off disease.
Today more than 40 antiretroviral drugs are approved. Most people who treat their HIV will take two or more of these drugs every day for the rest of their lives.
Antiretroviral drugs must be taken at the right time and in the right way for them to work properly. Taking these medications the way a healthcare provider has prescribed them is called adherence.1
There are several classes of drugs available for treatment. Each of them works to minimize the effect of HIV/AIDS on the immune system; none are a cure. The most common are the following:
Integrase inhibitors (INSTIs):
A class of medication that stops the action of the integrase enzyme. This is a viral enzyme that HIV uses to infect T-cells. Integrase inhibitors are usually among the first HIV drugs used in people who have recently contracted HIV because they work well and have minimal side effects.
Examples of these drugs include:
- Dolutegravir (Tivicay)
- Elvitegravir (Vitekta)
- Raltegravir (Isentress)
- Raltegravir extended release (Isentress HD)2
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs):
These work by interrupting the life cycle of HIV as it tries to copy itself. These drugs also have other actions that prevent HIV from replicating in the body.
Examples of NRTIs include:
- Abacavir (Ziagen)
- Abacavir/lamivudine (Epzicom)
- Abacavir/lamivudine/zidovudine (Trizivir)
- Lamivudine/zidovudine (Combivir)
- Lamivudine (Epivir)
- Zidovudine (Retrovir)
- Emtricitabine/tenofovir disoproxil fumarate (Truvada)
- Emtricitabine (Emtriva)
- Tenofovir disoproxil fumarate (Viread)
- Emtricitabine/tenofovir alafenamide (Descovy)2
Non-nucleoside reverse transcriptase inhibitors (NNRTIs):
These drugs work in a similar way to NRTIs. They stop the virus from replicating itself in the body.
Examples of these drugs include:
- Efavirenz (Sustiva)
- Etravirine (Intelence)
- Nevirapine (Viramune)
- Nevirapine extended release (Viramune XR)
- Rilpivirine (Edurant)
- Delavirdine mesylate (Rescriptor): Rarely used2
Protease inhibitors (PIs):
These work by binding to protease. This is a protein that HIV needs to replicate in the body. When protease can’t do its job, the virus can’t complete the process that makes new copies. This reduces the number of viruses that can infect more cells. Some protease inhibitors are only approved by the FDA to treat hepatitis C, but these are not the same as those used to treat HIV infection.
Examples of protease inhibitors used to treat HIV include:
- Atazanavir/cobicistat (Evotaz)
- Darunavir/cobicistat (Prezcobix)
- Lopinavir/ritonavir (Kaletra)
- Atazanavir (Reyataz): Often given together with Ritonavir
- Darunavir (Prezista): Must be given together with Ritonavir
- Fosamprenavir (Lexiva): Often given together with Ritonavir
- Tipranavir (Aptivus): Must be given together with Ritonavir2
Because HIV affects the immune system, researchers are studying ways that biological drugs can prevent viral replication. Certain immune-based treatments have been successful in some people in clinical trials and are currently being researched. They would be used along with other HIV medications.2
These treatments, while effective, do have side effects that make finding an individualized treatment plan difficult. The most common are diarrhea, dizziness, headaches, fatigue, fever, muscle aches, nausea and vomiting.