HIV Medications, An Effective Treatment To Live A Healthy Life

HIV (Human immunodeficiency virus) infection continues to be a major public health concern globally. Unlike some other viruses, the body cannot completely get rid of the HIV virus. Researchers are working continuously on finding medicines that eliminate HIV from the body. The currently available HIV medications offer hope to infected people by extending their lives through successful infection control. Let’s know more about HIV medications.

What Are HIV Medications?

HIV medications slow the rate at which the virus grows, reduce the amount of virus in the body and help you stay healthy and longer. It helps keep the immune system strong and reduces the symptoms and risk of virus transmission to others. HIV medication is also known as antiretroviral therapy (ART). 

If people delay the treatment, the virus will gradually destroy the infection-fighting cells (CD4 T lymphocyte) of the immune system. Loss of these immune cells makes it hard for the body to fight off infections and some cancers. Without treatment, an individual with HIV is likely to develop a serious condition called AIDS (acquired immunodeficiency syndrome).

People should begin treatment for HIV as soon as they know they are infected. People who have other infections such as hepatitis and pregnant women should be extra cautious in starting the treatment soon. 

Getting and keeping undetectable viral load: The amount of HIV virus in the blood is called viral load. HIV medication can make viral load so low that a test cannot detect it, known as undetectable viral load. It is a sign that a medication is working well, and most people reach this stage within six months of starting treatment. People having undetectable viral load are essentially at no or less risk of transmitting the virus.

Side effects & drug resistance: Different HIV medications can cause different side effects. Also, people taking the same medication can have different side effects. The most common side effects are dry mouth, dizziness, fatigue, pain, rash, headache, difficulty sleeping, nausea, vomiting, diarrhea, and dry mouth.

Take medicines as prescribed. If people diagnosed with HIV take medicines inconsistently (skip or miss doses), drug resistance will develop. It means the virus can mutate and will no longer respond to certain medications. Advanced medications will be required to control the infection.

What Are The Different Types Of HIV Medications?

Some medications block or change the enzymes that the HIV virus needs for duplicating, and this prevents the HIV from copying itself and lowers the amount of virus in the body. 

a. Nucleoside Reverse Transcriptase Inhibitors (NRTIs) – disrupt the activity of HIV enzyme reverse transcriptase and interrupt the virus from duplicating.

• Abacavir
• Emtricitabine
• Lamivudine
• Tenofovir disoproxil fumarate
• Zidovudine

b. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) – directly bind to and stop the activity of HIV’s reverse transcriptase enzyme.

• Doravirine
• Efavirenz
• Etravirine
• Nevirapine
• Rilpivirine

c. Integrase inhibitors – blocks HIV enzyme integrase and interrupt the virus from duplicating.

• Dolutegravir
• Raltegravir
• Cabotegravir

d. Protease inhibitors – blocks the activity of HIV protease enzyme and prevents viral replication

• Atazanavir
• Darunavir
• Fosamprenavir
• Ritonavir
• Saquinavir
• Tipranavir

Some HIV medications interfere with HIV’s ability to infect healthy cells. 

a. Fusion inhibitors – bind to the attachment sites of the HIV virus and block the virus from entering healthy cells (CD4 cells of the immune system).

• Enfuvirtide

b. CCR5 Antagonists – blocks the CCR5 receptor on the surface of certain immune cells and prevents HIV from entering uninfected cells. The CCR5 receptor is a predominant route of entry for HIV to enter the cells.

• Maraviroc

c. Attachment inhibitors – binds to the gp 120 portion of the HIV envelope protein. This prevents the virus from entering the cell.

• Fostemsavir

d. Post-attachment inhibitors – block the CD4 receptors on the surface of some immune cells that HIV needs to enter the healthy cells.

• Ibalizumab

Combination Medications

In some cases, people need to take more than one medicine.

a. Pharmacokinetic enhancers – These agents boost the effectiveness of certain HIV medications. They slow the breakdown of target medicine and allow the medicine to stay in the body at higher concentrations.

• Cobicistat boosts the levels darunavir, atazanavir, or elvitegravir.
  • Evotaz (atazanavir/ cobicistat)
  • Rezolsta (darunavir/ cobicistat)
  • Genvoya (elvitegravir/ cobicistat/ tenofovir alafenamide/ emtricitabine)

b. Multidrug combinations – a single pill contains two or more different HIV medications.

• Abacavir + lamivudine
• Abacavir + dolutegravir + lamivudine
• Abacavir + lamivudine + zidovudine
• Bictegravir + emtricitabine + tenofovir alafenamide
• Cabotegravir + Rilpivirine
• Dolutegravir + lamivudine
• Dolutegravir + Rilpivirine
• Doravirine + lamivudine + tenofovir disoproxil fumarate
• Efavirenz + lamivudine + tenofovir disoproxil fumarate
• Lopinavir + ritonavir
• Lamivudine + zidovudine
• Emtricitabine + tenofovir disoproxil fumarate
• Emtricitabine + tenofovir alafenamide
• Emtricitabine + tenofovir disoproxil fumarate + Rilpivirine
• Emtricitabine + tenofovir alafenamide + Rilpivirine

What Are HIV Prevention Medications/ Pre-Exposure Prophylaxis Or Prep?

PrEP is a medicine used to prevent getting HIV. This medicine is recommended for HIV-negative people who are at high risk of becoming infected with this virus. When taken as prescribed, it is highly effective and reduces the risk of getting HIV by 99%. PrEP is a combination of two antiretroviral medicines, tenofovir and emtricitabine. 

PrEP may be a good choice in people who are sexually active and inconsistently use condoms, people who have sex or trying to conceive with an HIV-positive partner, and people who have injection drug use. It can be discontinued if your risk for HIV changes and protection is not required. 

HIV prevention medication does not provide protection against STIs (sexually transmissible infections) such as gonorrhea, chlamydia, and syphilis. Condoms can provide protection against these infections. Most people don’t experience side effects, while some may have a loss of appetite, nausea, and headaches. 

Before prescribing PrEP, your doctor will organize some tests to check for HIV and other STIs along with kidney and liver function tests. People taking HIV prevention medication will repeatedly be (every three months) tested to make sure they have not been infected.

Get Support:

Depression is most common among HIV patients, and there are still many stigmas attached to HIV. Being depressed can make it hard to stick with a treatment plan. You can discuss your mental health problems with your health care professional. He/ she may refer you to a psychiatrist, psychologist, or therapist.