Antiretroviral Therapy 2023

What is Antiretroviral Therapy (ART)?

Antiretroviral therapy (ART) is the treatment used for people with HIV (human immunodeficiency virus). It involves the use of anti-HIV agents under different drug classifications. It also includes the consumption of combination drugs, making treatment and HIV management easier.

How does ART work?

Although not a cure for the infection, antiretroviral drugs have a positive impact on an HIV-positive individual. These benefits are as follows:

• They prevent HIV from advancing to AIDS (acquired immunodeficiency syndrome).
• They inhibit the virus from replicating or making more copies of itself.
• They boost the functions of the immune system.
• They prevent further HIV transmission.
• They reduce HIV-related complications.

Classes of HIV drugs

There are different classes of HIV drugs under antiretroviral therapy. They include the following:

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

NNRTIs work by binding to reverse transcriptase, an HIV enzyme. They block the virus from its replication process. The list of NNRTIs is as follows:

• Sustiva
• Viramune
• Intelence
• Pifeltro
• Viramune XR
• Rescriptor
• Edurant

Nucleoside reverse transcriptase inhibitors (NRTIs)

NRTIs control HIV infection by stopping the virus from multiplying. They halt HIV in its earliest cycle and prevent the virus from spreading. The list of NRTIs is as follows:

• Ziagen
• Emtriva
• Epivir
• Vemlidy
• Viread
• Retrovir

Protease inhibitors (PIs)

PIs work by preventing viral growth throughout the body. They specifically prevent an enzyme, called protease, that HIV requires to replicate. The list of PIs is as follows:

• Reyataz
• Prezista
• Lexiva
• Crixivan
• Kaletra
• Viracept
• Norvir
• Invirase
• Aptivus
• Evotaz
• Prezcobix

Integrase inhibitors

Integrase inhibitors work by blocking an essential protein that allows HIV to incorporate its DNA into the healthy cell DNA of the body. The list of integrase inhibitors includes:

• Biktarvy
• Tivicay
• Vitekta
• Isentress
• Cabenuva

Fixed-dose combinations

Part of antiretroviral therapy is the use of combination drugs to make treatment easier. These include the following:

Non-nucleoside reverse transcriptase inhibitor (NNRTI):

• Doravirine + tenofovir disoproxil fumarate + lamivudine (Delstrigo)
• Efavirenz + tenofovir disoproxil fumarate + emtricitabine (Atripla)
• Rilpivirine + tenofovir alafenamide + emtricitabine (Odefsey)
• Rilpivirine + tenofovir disoproxil fumarate + emtricitabine (Complera)

Nucleoside/nucleotide reverse transcriptase inhibitor (NRTI):

• Abacavir + lamivudine (Epzicom)
• Abacavir + lamivudine + zidovudine (Trizivir)
• Tenofovir alafenamide + emtricitabine (Descovy)
• Tenofovir disoproxil fumarate + emtricitabine (Truvada)
• Tenofovir disoproxil fumarate + lamivudine (Cimduo)
• Zidovudine + Lamivudine (Combivir)

Protease inhibitor (PI):

• Atazanavir + cobicistat (Evotaz)
• Darunavir + cobicistat (Prezcobix)
• Darunavir + cobicistat + tenofovir alafenamide + emtricitabine (Symtuza)

Integrase strand transfer inhibitor (INSTI):

• Bictegravir + tenofovir alafenamide + emtricitabine (Biktarvy)
• Dolutegravir + abacavir + lamivudine (Triumeq)
• Dolutegravir + rilpivirine (Juluca)
• Dolutegravir + lamivudine (Dovato)
• Elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine (Genvoya)
• Elvitegravir + cobicistat + tenofovir disoproxil fumarate + emtricitabine (Stribild)

More classes of HIV drugs are either new or not commonly used to treat the infection. These are as follows:

• Fusion Inhibitors
• Capsid Inhibitor
• Gp120 Attachment Inhibitor
• CCR5 Antagonist
• Post-Attachment Inhibitor

Pharmacologic Enhancers