Types of Medication for HIV

Human immunodeficiency virus (HIV) is a virus that attacks the cells of the immune system. These cells (CD4+) help the body to resist any infections. With the lack of these cells, the body’s resistance power comes down, making it vulnerable to other infections and diseases. HIV spreads mainly via bodily fluids of the person (blood and semen) with HIV, e.g., during unprotected sex or sharing injection drug equipment.

If untreated, HIV can lead to AIDS (acquired immunodeficiency syndrome). Hence, treating HIV with antiretroviral therapy (HIV medicine) is necessary to reduce the viral load and prevent transmitting HIV to sexual partners.

The most common medications used for the treatment of HIV include:

• Nucleoside reverse transcriptase inhibitors (NRTIs): These drugs block the action of an enzyme called reverse transcriptase that HIV needs to make copies of itself. Some examples include:
  • Abacavir
  • Didanosine
  • Emtricitabine
  • Epivir
  • Lamivudine
  • Stavudine
  • Tenofovir DF
  • Zidovudine
• Non-NRTIs (NNRTIs): They bind to reverse transcriptase and later alter it to prevent HIV from making copies of itself. Some examples include:
  • Cabotegravir/rilpivirine
  • Delavirdine
  • Dolutegravir/rilpivirine
  • Doravirine
  • Efavirenz
  • Etravirine
  • Nevirapine
  • Rilpivirine
• Protease inhibitors: These drugs block the action of an enzyme called protease that is essential for HIV to mature and spread. Some examples include:
  • Atazanavir
  • Darunavir
  • Fosamprenavir
  • Indinavir
  • Lopinavir/ritonavir
  • Nelfinavir
  • Ritonavir
  • Saquinavir
  • Tipranavir
• Fusion inhibitors: These drugs prevent the fusion of the virus to the CD4 cells of the immune system. Examples include:
  • Enfuvirtide
• CCR5 antagonist: These drugs block the entry of HIV cells into the immune system of humans by blocking the coreceptor CCR5 in the CD4 cells of the immune system. Maraviroc is the only FDA-approved drug in this class.
• CD4 post-attachment inhibitors: These drugs prevent HIV from infecting the CD4 cells of the immune system. Ibalizumab is an FDA-approved drug used for treating HIV infection.
• Pharmacokinetic enhancer: These drugs boost the effectiveness of HIV drugs. Cobicistat is approved for the treatment of HIV infection.

A combination of antiretroviral drugs is the most effective in treating HIV infection. Combination therapy usually consists of two or more drugs from several different drug classes. It has the best chance of reducing the HIV load in the blood.

Common side effects of NRTIs include:

• Headache
• Nausea
• Vomiting
• Diarrhea
• Upset stomach
• Chills
• Dizziness
• Rash
• Indigestion
• Muscle aches
• Depression
• Abdominal pain and cramps
• Insomnia

Common side effects of NNRTIs include:

• Rash
• Headache
• Insomnia
• Depression
• Nausea
• Vomiting
• Fatigue
• Abdominal pain
• Dizziness

Common side effects of protease inhibitors include:

• Fever
• Rash
• Nausea
• Cough
• Diarrhea
• Headache
• Jaundice
• Insomnia
• Muscle aches
• Dizziness
• Abdominal pain
• Depression
• Fatigue

Common side effects of fusion inhibitors include:

• Pain and discomfort
• Redness
• Itching
• Diarrhea
• Nausea
• Fatigue
• Insomnia
• Depression
• Weight loss
• Cough
• Muscle aches

Common side effects of CCR5 antagonists include:

• Upper respiratory infections
• Cough
• Fever
• Rash
• Dizziness
• Depression
• Itching
• Herpes infection
• Constipation
• Appetite disorder
• Muscle pain
• Indigestion

Common side effects of CD4 post-attachment inhibitors include:

• Diarrhea
• Dizziness
• Nausea
• Rash
• Itching
• Hypersensitive reactions

Common side effects of pharmacokinetic enhancers include:

• Diarrhea
• Nausea
• Altered taste
• Fatigue
• Vomiting
• Rash
• Abdominal pain
• Coughing

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Most HIV medicines are safe to use during pregnancy. Mostly, these drugs do not alleviate the risk of birth defects in the fetus.

While recommending HIV medicines, the physician may weigh the benefits of the drug against its risks. All pregnant women with HIV should take HIV medications during pregnancy to prevent any complications and transmission of HIV to the fetus.

Although there are no known interactions between alcohol and HIV medications, drinking alcohol can worsen the symptoms of HIV. People who drink alcohol regularly may have increased viral load with reduced immunity. It is better to either avoid alcohol or consult your physician before drinking alcohol.