Understanding Different HIV Medications

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Table of Contents

I. The Prevalence of HIV

II. Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

III. Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

IV. Protease Inhibitors

V. Integrase Inhibitors

VI. Combination HIV Medications

The Prevalence of HIV

HIV stands for human immunodeficiency virus. Around 1.2 million people in the United States are living with HIV. In the past, HIV was a death sentence for many, but today people can often successfully live with the virus. Despite technological innovations in medicine, HIV still disproportionately impacts ethnic minorities, as well as gay and bisexual men. Since the height of HIV/AIDS, the rate of HIV has reduced by one third, but there are still tens of thousands of new HIV infections every year.

HIV is spread through activities like:

  • Having vaginal or anal sex with an HIV positive person
  • Sharing needles with someone who has HIV
  • From mother to child during pregnancy, birth, or breastfeeding
  • Blood transfusions or organ transplants contaminated with HIV 

People are much more knowledgeable about how HIV is transmitted today than they were in the past. A few decades ago, people were confused about transmitting the virus and thought it was spread by innocuous activities like drinking from a water fountain, shaking hands, or sharing silverware.

Along with greater knowledge, the modern medical world has developed several medications to prolong the life of HIV patients, reduce transmission, and reduce symptoms. Read on to learn more about the different types of HIV drugs.

a needle with the tip taken off

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

The treatment for HIV involves the use of antiretroviral drugs. When HIV takes hold of the body, it enters cells that are part of the immune system (T cells). These drugs disrupt the ability of the virus to multiply or reproduce. NRTIs block enzymes that the virus requires to make copies of itself. Once the virus enters the T cells, it copies the RNA (the HIV genetic makeup) and inserts it into the cell's DNA. This is known as reverse transcription.

Patients must take this medication daily for proper usage. Over time, the virus may mutate and become resistant to the NRTI, and a patient might have to try an alternate NRTI. These drugs will not cure HIV but can help control it. Your doctor may prescribe another antiretroviral drug along with an NRTI to assist in controlling HIV. NRTIs can include:

  • Ziagen (abacavir)
  • Epivir (lamivudine)
  • Viread (tenofovir disoproxil fumarate)
  • Retrovir (zidovudine, formerly azidothymidine [AZT])

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) 

NNRTIs differ slightly from NRTIs. Whereas NRTIs integrate into the T cell’s DNA, NNRTIs bind directly to HIV’s transcriptase enzyme and inhibit its activity. These drugs sometimes have a higher rate of drug interactions, so your doctor may keep a closer eye on you when taking this type of antiretroviral drug. If you are taking these drugs, you may want to look out for side effects, including:

  • Rash
  • Headache
  • Liver toxicity

These side effects often resolve themselves within a few weeks of beginning treatment. Your doctor may prescribe the following NNRTIs:

Protease Inhibitors

Once HIV enters the body, the virus’s main goal is to replicate as much as possible. HIV cannot reproduce itself and must infect T cells to spread the virus throughout the body. Protease is one of the essential enzymes that assist in HIV replication. If you take a protease inhibitor drug, it prevents protease from allowing the virus to multiply and interrupts the HIV life cycle. You may be prescribed the following protease inhibitors:

In general, these drugs are often used in combination with drugs like ritonavir or cobicistat. Protease inhibitors may cause a few side effects like changes in how foods taste, fat distribution, and insulin resistance. If you take over-the-counter drugs, herbs, and supplements, you may experience an interaction with protease inhibitors. You may want to tell your doctor if you use any of these products.

Integrase Inhibitors

Once HIV is in the body, it makes an enzyme called integrase. This enzyme takes over T cells and copies itself, proliferating HIV throughout the bloodstream. The use of integrase inhibitors makes it so that the virus cannot create integrase, preventing its replication. Patients may use other HIV medications with this drug to keep HIV under control. Isentress (raltegravir) is one common integrase inhibitor that is commonly used.

someone handling several blood samples

This type of drug is often used as one of the first medications a newly diagnosed HIV patient will take. These drugs often have fewer side effects than other drugs, but you may experience:

  • Dizziness
  • Headache
  • Insomnia
  • Nausea
  • Fatigue

Combination HIV Medications

Combination medications implement several antiretroviral drugs in a patient’s HIV treatment. The combination method is most often used for those who have never taken HIV drugs before. Typically, a combination drug plan includes drugs from different drug classes. Protease and integrase inhibitors are often involved in a combination HIV treatment. These drugs include:

  • Epzicom (abacavir/lamivudine)
  • Trizivir (abacavir/lamivudine/zidovudine)
  • Atripla (efavirenz/emtricitabine/tenofovir)
  • Genvoya(elvitegravir/cobicistat/emtricitabine/tenofovir)
  • Stribild (elvitegravir/cobicistat/emtricitabine/tenofovir)
  • Truvada (emtricitabine/tenofovir)
  • Combivir (lamivudine/zidovudine)
  • Kaletra (lopinavir/ritonavir)

Treating HIV can be a long process, and you may need to try several different types of antiretroviral drugs to prevent HIV from replicating in your system. Those with HIV can live a long and healthy life with the proper medication, so talk to your doctor to discuss the best medications for you.

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