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HIV Treatments: List of Prescription Medications 2020

The effects of HIV

HIV is transmitted through contact with blood, semen, breast milk, or other bodily fluids that contain the virus. HIV targets the immune system and invades T cells, which are white blood cells that fight infection.

After the virus invades the T cells, it replicates (makes copies of itself). Then the cells burst open. They release many viral cells that go on to invade other cells in the body.

This process destroys the immune system’s ability to fight infections and generally keeps the body from working well.

There’s currently no known cure for HIV. However, medications can help people living with HIV manage the condition and lead healthy lives. These drugs work by stopping HIV from replicating.

Here’s a list of drugs, known as antiretrovirals, that are currently approved by the Food and Drug Administration (FDA) to treat HIV.

Classes of antiretroviral drugs for HIV

Integrase strand transfer inhibitors (INSTIs)

Integrase inhibitors stop the action of integrase. Integrase is a viral enzyme that HIV uses to infect T cells by putting HIV DNA into the human DNA.

Integrase inhibitors are usually among the first HIV drugs used in people who have recently contracted HIV. This is because they work well and have minimal side effects.

The following drugs are integrase inhibitors:
·        bictegravir (not available as a stand-alone drug, but available in the combination drug Biktarvy)
·        dolutegravir (Tivicay)
·        elvitegravir (not available as a stand-alone drug, but available in the combination drugs Genvoya and Stribild)
·        raltegravir (Isentress, Isentress HD)
These drugs belong to a well-established category of integrase inhibitors known as integrase strand transfer inhibitors (INSTIs). Other, more experimental categories of integrase inhibitors include integrase binding inhibitors (INBIs), but there are no FDA-approved INBIs to treat HIV.

Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)

NRTIs are sometimes referred to as “nukes.” They work by interrupting the life cycle of HIV as it tries to copy itself. These drugs also have other actions that prevent HIV from replicating in the body.

The following drugs are NRTIs:

Combination NRTIs

The following combination drugs are made up of either two or three NRTIs:

·        abacavir, lamivudine, and zidovudine (Trizivir)
·        abacavir and lamivudine (Epzicom)
·        emtricitabine and tenofovir alafenamide fumarate (Descovy)
·        emtricitabine and tenofovir disoproxil fumarate (Truvada)
·        lamivudine and tenofovir disoproxil fumarate (Cimduo, Temixys)
·        lamivudine and zidovudine (Combivir)

Descovy and Truvada may also be prescribed to some people without HIV as part of a pre-exposure prophylaxis (PrEP) regimen.

Rarely used NRTIs

The following NRTIs are rarely used and will be discontinued by their manufacturers in 2020:

didanosine (Videx, Videx EC)
stavudine (Zerit)

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

These drugs work in a similar way to NRTIs. They stop the virus from replicating itself in the body.

The following drugs are NNRTIs, or “non-nukes”:

·        doravirine (Pifeltro)
·        efavirenz (Sustiva)
·        etravirine (Intelence)
·        nevirapine (Viramune, Viramune XR)
·        rilpivirine (Edurant)

Cytochrome P4503A (CYP3A) inhibitors

Cytochrome P4503A is an enzyme in the liver that helps several functions in the body, including breaking down or metabolizing medications. Cytochrome P4503A inhibitors, also known as CYP3A inhibitors, increase the levels of certain HIV drugs (as well as other non-HIV drugs) in the body.

The following drugs are CYP3A inhibitors:

cobicistat (Tybost)
ritonavir (Norvir)
Cobicistat doesn’t have the ability to promote anti-HIV activity when it’s used alone, so it’s always paired with another antiretroviral.

Ritonavir can promote anti-HIV activity when it’s used alone. However, to achieve this, it must be used in much higher doses than people can typically tolerate. It’s prescribed alongside other HIV drugs as a booster drug: It helps to enhance the performance of the other drugs.



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