Connect with others who've been there. Share stories. Learn. Join Mayo Clinic's
online community.

Free

E-Newsletters

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer
View the Health Heart Book

Treatments and drugs

By Mayo Clinic staff

There is no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each of the classes of anti-HIV drugs blocks the virus in different ways. It's best to combine at least three drugs from two different classes to avoid creating strains of HIV that are immune to single drugs. The classes of anti-HIV drugs include:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
  • Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).
  • Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
  • Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
  • Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its genetic material into CD4 cells.

When to start treatment
Current guidelines indicate that treatment should begin if:

  • You have severe symptoms
  • Your CD4 count is under 500
  • You're pregnant
  • You have HIV-related kidney disease
  • You're being treated for hepatitis B

Treatment can be difficult
HIV treatment regimens may involve taking multiple pills at specific times every day for the rest of your life. Side effects can include:

  • Nausea, vomiting or diarrhea
  • Abnormal heartbeats
  • Shortness of breath
  • Skin rash
  • Weakened bones
  • Bone death, particularly in the hip joints

Treatment response
Your response to any treatment is measured by your viral load and CD4 counts. Viral load should be tested at the start of treatment and then every three to four months while you're undergoing therapy. CD4 counts should be checked every three to six months.

HIV treatment should reduce your viral load to the point that it's undetectable. That doesn't mean your HIV is gone. It just means that the test is not sensitive enough to detect it. You can still transmit HIV to others when your viral load is undetectable.

Lifestyle and home remedies Tests and diagnosis
References
  1. Basic information about HIV and AIDS. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/topics/basic/index.htm. Accessed May 18, 2010.
  2. HIV and its treatment: What you should know. AIDSinfo. U.S. Department of Health and Human Services. http://aidsinfo.nih.gov/contentfiles/HIVandItsTreatment_cbrochure_en.pdf. Accessed May 18, 2010.
  3. Kumar V, et al. Immunodeficiency syndromes. In: Kumar V, et al. Robbins and Cotran Pathologic Basis of Disease, Professional Edition. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/202273019-4/0/2060/57.html?tocnode=57529567&fromURL=57.html#4-u1.0-B978-1-4377-0792-2..50011-0--cesec96_437. Accessed May 18, 2010.
  4. Quinn TC. The global human immunodeficiency virus pandemic. http://www.uptodate.com/home/index.html. Accessed May 18, 2010.
  5. Opal SM, et al. Human immunodeficiency virus. In: Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/202273019-4/1002085996/2088/313.html#4-u1.0-B978-0-323-05609-0..00017-4--sc0185_6437. Accessed May 18, 2010.
  6. Bartlett JG. The stages and natural history of HIV infection. http://www.uptodate.com/home/index.html. Accessed May 18, 2010.
  7. Opal SM, et al. Acquired immunodeficiency syndrome. In: Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/202273019-4/1002085996/2088/22.html#4-u1.0-B978-0-323-05609-0..00010-1--s1620_340. Accessed May 18, 2010.
  8. Living with AIDS. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/resources/brochures/livingwithhiv.htm. Accessed May 19, 2010.
  9. Neurological complications of AIDS fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/aids/detail_aids.htm. Accessed May 21, 2010.
  10. Bartlett JG. When to initiate antiretroviral therapy in HIV-infected patients. http://www.uptodate.com/home/index.html. Accessed May 21, 2010.
  11. Side effects of anti-HIV medications: Health information for patients. AIDSinfo. U.S. Department of Health and Human Services. http://aidsinfo.nih.gov/contentfiles/SideEffectAnitHIVMeds_cbrochure_en.pdf. Accessed May 21, 2010.
  12. Eating defensively: Food safety advice for persons with AIDS. U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/HIVandAIDSActivities/ucm135844.htm. Accessed May 21, 2010.
  13. Natural medicines in the clinical management of HIV/AIDS. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 21, 2010.
  14. The HIV/AIDS programs: Find HIV/AIDS care. U.S. Department of Health and Human Services. http://hab.hrsa.gov/findcare/index.htm. Accessed May 21, 2010.
  15. Fourth generation HIV diagnostic test approved, permitting earlier detection of infection. Food and Drug Administration. http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/HIVandAIDSActivities/ucm216409.htm. Accessed June 24, 2010.
  16. FDA approves first-of-its-kind HIV test which can detect HIV days earlier than current U.S. tests. Abbott Laboratories. http://www.abbott.com/global/url/pressRelease/en_US/60.5:5/Press_Release_0875.htm. Accessed June 24, 2010.
  17. Daar ES, et al. Clinical presentation and diagnosis of primary HIV-1 infection. Current Opinion in HIV and AIDS. 2008;3:110.
  18. Sax, PE. Primary HIV-1 infection: Pathogenesis; epidemiology and clinical manifestations. http://www.uptodate.com/home/index.html. Accessed Oct. 17, 2011.
  19. Stages of HIV. U.S. Department of Health and Human Services. http://www.aids.gov/hiv-aids-basics/diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/. Accessed Oct. 19, 2011.
  20. Fauci A, et al. Human immunodeficiency virus disease: AIDS and related disorders. In: Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Oct. 19, 2011.
DS00005 Oct. 20, 2011

© 1998-2012 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

  • Reprints
  • Print

  • Share on:

  • Email

Advertisement


Text Size: smaller largerlarger