What is antiretroviral therapy (ART)?

Usually, the medication that refers to treat the HIV infection belongs to the group of antiretroviral medication. The process of treating HIV or Aids in humans with the help of medication is antiretroviral therapy (ART). People who are at the initial stage and diagnose with HIV usually get the recommendation to start the therapy. It is not a cure but a relief that helps to avoid the complications and lead a normal lifestyle. in most chronical conditions antiretroviral therapy helps to slow down viruses to spread inside the body or to others as well.

Protease inhibitors (PIs)

Protease inhibitors belong to the antiretroviral medication group and help in the treatment of HIV/AIDS. These are the drugs with the characters to stop the virus multiplication. It breakdown the protein or block it to perform the function that is necessary to make virus survival possible. The continuous use of the drugs as per prescription will help to stop the infection spread to other cells inside the human body.

Rarely used PIs

There is some protease inhibitor that are rarely used for HIV treatment. The main reason to not use such drugs is the high ratio of the possible side effects. Here is some rarely used protease inhibitors:

• Indinavir
• Nelfinavir
• Saquinavir

Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)

In the body HIV needs the perfect supply of building blocks including proteins to continue the virus multiplication process. The use of Nucleoside Reverse Transcriptase Inhibitors is useful to stop and restrict the supply of the proteins. Moreover, it provides an inactive protein source that will not help in the process of the growth or spread of the virus inside the body.

Combination NRTIs

The combination NRTIs are as following:

• Abacavir
• Didanosine
• Lamivudine
• Tenofovir alafenamide
• Zidovudine
• Stavudine

Integrase strand transfer inhibitors (INSTIs)

HIV uses the enzyme integrase to trigger the multiplication process of the virus inside the body. It is an important factor of the treatment to stop the action of this instigation by blocking the integrase. With the integrase inhibitors (INSTIs) it is easier to stop the function of the enzyme and not let it allow to infect the T-cells inside the body. INSTIs don’t have many side effects and prove effective for those who are recently in contact with HIV.

Cytochrome P4503A (CYP3A) inhibitors

The body will perform a function with the help of multiple enzymes and elements. Similarly, Cytochrome P4503A (CYP3A) is an enzyme present in the liver that effectively participates in metabolic functions. With the help of Cytochrome P4503A inhibitor, it is easier to increase the level of HIV drugs inside the body that fight the virus. Mostly this drug is used or prescribed in combination with other HIV drugs for better results.

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

The purpose of using HIV medications is to stop the virus spread inside the body. With the non-nucleoside reverse transcriptase inhibitors, it is easier to stop the multiplication of the virus. It binds directly with the protein that plays role in the multiplication of HIV and stops the process. Further, the virus will not be able to develop the copies due to the protein blockage. It is an effective medication on its own or useful to combine with other medications for best results.

Chemokine coreceptor antagonists (CCR5 antagonists)

Chemokine Coreceptor antagonists work to block the entry of the virus inside the cells. It helps to save the T-cells from the virus intact and control the spread of the virus effectively. Usually, CCR5 antagonists are used in combination or alone to treat HIV or avoid possible complications due to the virus. Maraviroc is the only available CCR5 antagonist that works for HIV patients to avoid future complications.

Fusion inhibitors

Fusion inhibitors are one the classes of HIV medications that work effectively to treat it. The spread of HIV is only possible when there’s a suitable atmosphere to grow and start the multiplication process. The virus requires the host’s T-cells inside the body to do the replication. The use of fusion inhibitor blocks the virus from entering the T-cells. It saves cell damage, stops virus replication and blocks the spread.

Enfuvirtide as a commonly used fusion inhibitor prescribed by health advisors to treat HIV.

Entry inhibitors

The use of the entry inhibitors is considered effective to treat HIV and to stop its spread. In the antiretroviral medications group, the use of all big group medicines is proven to be an effective element to treat the virus. Usually, the CCR5, fusion inhibitors, and others are all considered as entry inhibitors. The purpose of entry inhibitor medications is to stop the spread of the virus and prevent its entry inside the T-cells to stop the influence of the virus over the healthy cells.

In general, enfuvirtide, ibalizumab-quirky, and maraviroc are classified to be entry inhibitors that stop the virus entry.

Combination drugs

Combination drugs are commonly used for treatment of HIV, and it’s when different medications are combined in one drug. It helps in the prescription that the doctor can advise the one drug instead of recommending more than one. Most combination drugs for tthe treatment of HIV contain protease inhibitors and CYPA3A to effectively work against the virus. Some combination drugs also contain NRTIs.

Some combination drugs consisting of PI and CYPA3A are:

• Atazanavir and cobicistat
• Lopinavir and ritonavir

Combination drugs consisting of NRTIs:

• Abacavir, lamivudine and zidovudine
• Amtricitabine and tenofovir alafenamide fumarate
• Lamivudine and tenofovir disoproxil fumarate
• Lamivudine and zidovudine

There are many more combination drugs available in the market that are considered effective for the treatment of HIV.

Multiclass combination drugs or single-tablet regimens (STRs)

There is a wide variety of drugs among multiclass combination drugs, that help the treatment of HIV and give effective results.

There are some combination drugs include NRTIs and NNRTIs:

• Emtricitabine, rilpivirine, and tenofovir alafenamide fumarate
• Emtricitabine, rilpivirine, and tenofovir disoproxil fumarate
• Doravirine, lamivudine, and tenofovir disoproxil fumarate
• Efavirenz, lamivudine, and tenofovir disoproxil fumarate
• Efavirenz, lamivudine, and tenofovir disoproxil fumarate
• Efavirenz, emtricitabine, and tenofovir disoproxil fumarate

Combination drugs consisting of NRTIs, INSTI, CYP3A:

• Elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate
• Elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide fumarate

Combination drugs consisting of NRTI and INSTI to treat HIV:

• abacavir, dolutegravir, and lamivudine
• bictegravir, emtricitabine, and tenofovir alafenamide fumarate
• dolutegravir and lamivudine

Side effects & responses

Side effects of combination drgus vary from person to person. The common side effects are as following:

• Diarrhea
• Headache
• Dizziness
• Fever
• Nausea
• Skin aches or rashes
• Vomiting or others

Some of the side effects of combination drugs go away on their own after a period of time. But if they are persistent or get severe, it is suggested to consult a health care provider. Do not stop taking the drugs until the doctor prescribes you to do so. Moreover, the variation in the dosage should be followed as prescribed by the doctor.