What is HIV infection?
Human immunodeficiency virus (HIV) infection is caused by a virus that attacks the T-cells of the human immune system. This results in progressive weakening of the immune system leading to acquired immune deficiency syndrome (AIDS), when the body is no longer able to fight infection effectively. HIV has no cure and can only be controlled by lifelong medication.
What is antiretroviral therapy (ART) for HIV infection?
Antiretroviral therapy (ART) is a treatment regimen for HIV infection with a combination of three or more classes of drugs. Each drug class attacks the virus in a different way at different phases of its replication cycle. ART controls the viral growth and minimizes the chances of transmission of HIV infection.
What are the drug combinations for ART?
ART is usually tailored to suit individual requirements. Currently, seven classes of drugs are available individually, but can be combined for a complete ART regimen.
- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- Protease inhibitors (PIs)
- Integrase inhibitors (INSTIs)
- Fusion inhibitors (FIs)
- Chemokine receptor antagonists (CCR5 antagonists)
- Post-attachment entry inhibitors
The combination of a complete regimen typically consists of two NRTIs and one or more of the other drug classes, depending on the patient’s condition and stage of infection.
The ART drugs are also available in a single tablet form for people who find it difficult to take multiple pills. These single tablets are a complete regimen with a combination of three or four classes of drugs, each in a fixed dose.
Most of the fixed as well as individualized combination regimens also include a boosting drug (pharmacokinetic enhancer) which enhance the performance of ART drugs by delaying their breakdown and making them remain for a longer duration in the body. The boosting drug that is currently in use is cobicistat (Tybost).
What are the single tablet ART regimens for HIV infection?
Following is a list of single tablet fixed dose, complete ART regimens taken once a day:
Stribild
- Elvitegravir (150 mg) - (INSTI)
- Cobicistat (150 mg) - (Booster)
- Emtricitabine (200 mg) - (NRTI)
- Tenofovir DF (300 mg) - (NRTI)
Genvoya
- Elvitegravir (150 mg) - (INSTI)
- Cobicistat (150 mg) - (Booster)
- Emtricitabine (200 mg) - (NRTI)
- Tenofovir AF (10 mg) - (NRTI)
Symtuza
- Darunavir (800 mg) - (PI)
- Cobicistat (150 mg) - (Booster)
- Emtricitabine (200 mg) - (NRTI)
- Tenofovir AF (10 mg) - (NRTI)
Odefsey
- Rilpivirine (25 mg) - (NNRTI)
- Emtricitabine (200 mg) - (NRTI)
- Tenofovir AF (25 mg) - (NRTI)
Complera
- Rilpivirine (25 mg) - (NNRTI)
- Emtricitabine (200 mg) - (NRTI)
- Tenofovir DF (300 mg) - (NRTI)
Biktarvy
- Bictegravir (50 mg) - (INSTI)
- Emtricitabine (200 mg) - (NRTI)
- Tenofovir AF (25 mg) - (NRTI)
Triumeq
- Dolutegravir (50 mg) - (INSTI)
- Abacavir (300 mg) - (NRTI)
- Lamivudine (300 mg) - (NRTI)
Juluca
A complete regimen only for adults who have well-controlled infection, on a stable ART regimen for 6 months or more, with no history of drug resistance.
- Dolutegravir (50 mg) - (INSTI)
- Rilpivirine (25 mg) - (NNRTI)
Dovato
A complete regimen only for treatment-naïve adults with no known resistance to dolutegravir or lamivudine
- Dolutegravir (50 mg) - (INSTI)
- Lamivudine (300 mg) - (NRTI)
Atripla
May be used alone as a complete regimen or in combination with other ARTs.
- Efavirenz (600 mg) - (NNRTI)
- Emtricitabine (200 mg) - (NRTI)
- Tenofovir DF (300 mg) - (NRTI)
Symfi
- Efavirenz (600 mg) - (NNRTI)
- Lamivudine (300 mg) - (NRTI)
- Tenofovir DF (300 mg) - (NRTI)
Symfi Lo
- Efavirenz (400 mg) - (NNRTI)
- Lamivudine (300 mg) - (NRTI)
- Tenofovir DF (300 mg) - (NRTI)
Delstrigo
- Doravirine (100 mg) - (NNRTI)
- Lamivudine (300 mg) - (NRTI)
- Tenofovir DF (300 mg) - (NNRTI)
NRTI combinations
Nucleoside reverse transcriptase inhibitors form the backbone of ART combination. Following are the currently available fixed NRTI combinations that can be taken once a day, along with more drug classes as needed:
Descovy
- Emtricitabine (200 mg)
- tenofovir AF (25 mg)
Truvada
- Emtricitabine (200 mg)
- Tenofovir DF (300 mg)
Epzicom
- Abacavir (600 mg)
- Lamivudine (300 mg)
Cimduo
- Lamivudine (300 mg)
- Tenofovir DF (300 mg)
NRTI combinations taken twice a day
Trizivir
- Abacavir (300 mg)
- Lamivudine (150 mg)
- Zidovudine (300 mg)
Combivir
- Zidovudine (300 mg)
- Lamivudine (150 mg)
Protease inhibitor combinations
Two protease inhibitor combinations with the booster drug cobicistat that can be taken as a single pill along with NRTIs:
Evotaz
- Atazanavir (300 mg)
- Cobicistat (150 mg)
Prezcobix
- Darunavir ethanolate (800 mg)
- Cobicistat (150 mg)
SLIDESHOW
A Timeline of the HIV/AIDS Pandemic See SlideshowSummary
Antiretroviral Therapy (ART) for HIV is usually tailored to suit individual requirements. Currently, seven classes of drugs are available individually, but can be combined for a complete ART regimen, which usually contains three different drugs targeting the virus at different stages of replication. ART regimens are increasingly combined in single-tablet formulations to help patients comply with treatment and avoid the disease progressing into AIDS (acquired immunodeficiency syndrome).
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HIV Early Signs and Stages
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How Long Can You Live with HIV?
HIV stands for human immunodeficiency virus. If someone has HIV it means that they have been diagnosed with the HIV infection. AIDS (acquired immune deficiency syndrome); however, is the most advanced or final stage of the HIV infection. In the case of an untreated HIV infection, the overall mortality rate is more than 90%. The average time from infection to death is eight to ten years.
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Human Immunodeficiency Virus (HIV)
HIV (human immunodeficiency virus) infection left untreated causes AIDS (acquired immunodeficiency syndrome). The human immunodeficiency virus (HIV) is a type of virus called a retrovirus, which can infect humans when it comes in contact with tissues that line the vagina, anal area, mouth, or eyes, or through a break in the skin. HIV infection is generally a slowly progressive disease in which the virus is present throughout the body at all stages of the disease. Three stages of HIV infection have been described. The initial stage of infection (primary infection), which occurs within weeks of acquiring the virus, often is characterized by the flu- or mono-like illness that generally resolves within weeks. The stage of chronic asymptomatic infection (meaning a long duration of infection without symptoms) lasts an average of eight to 10 years without treatment. The stage of symptomatic infection, in which the body's immune (or defense) system has been suppressed and complications have developed, is called the acquired immunodeficiency syndrome (AIDS). The symptoms are caused by the complications of AIDS, which include one or more unusual infections or cancers, severe loss of weight, and intellectual deterioration (called dementia). When HIV grows (that is, by reproducing itself), it acquires the ability to change (mutate) its own structure. These mutations enable the virus to become resistant to previously effective drug therapy. The goals of drug therapy are to prevent damage to the immune system by the HIV virus and to halt or delay the progress of the infection to symptomatic disease. Therapy for HIV includes combinations of drugs that decrease the growth of the virus to such an extent that the treatment prevents or markedly delays the development of viral resistance to the drugs. The best combination of drugs for HIV are those that effectively suppress viral replication in the blood and also are well tolerated and simple to take so that people can take the medications consistently without missing doses.
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What Is the Difference Between HIV-1 and HIV-2?
There are two main types of the human immunodeficiency virus (HIV), HIV-1 and HIV-2. HIV-1 is the most common type of HIV and accounts for 95% of all infections, whereas HIV-2 is relatively uncommon and less infectious. HIV-2 is mainly concentrated in West Africa, is less deadly and progresses more slowly.
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How Long Does It Take to See Signs of HIV?
The signs and symptoms of HIV may first appear within two to four weeks of infection. The stage in which the symptoms appear is called the stage of acute HIV infection. The symptoms appear due to the resistance or fight of the immune system against HIV. Early diagnosis and treatment of HIV gets the best results.
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What Are the Four Stages of HIV?
The World Health Organization (WHO) classifies human immunodeficiency virus (HIV) into four stages. Stage 1 (HIV infection): The CD4+ cell count is at least 500 cells per microliter. Stage 2 (HIV infection): The CD4+ cell count is 350 to 499. Stage 3 (advanced HIV disease or AHD): The CD4+ cell count is 200 to 349. Stage 4 (Acquired immunodeficiency syndrome [AIDS]): The CD4+ cell count is less than 200.
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How Long Does It Take to Notice Signs of HIV?
HIV (human immunodeficiency virus) is a virus that attacks and damages the cells of the immune system in the body. If left untreated, HIV can lead to the AIDS (acquired immunodeficiency syndrome) disease. AIDS is the final stage of HIV infection which occurs when the body’s immune system is severely damaged because of the virus and unusual infections result. Untreated, HIV infection has a mortality of 90%.
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HIV vs. AIDS
Human immunodeficiency virus causes HIV infection. Acquired immunodeficiency syndrome (AIDS) is a condition that results after HIV has extensively damaged a person's immune system. Risk factors for HIV and AIDS include use of contaminated needles or syringes, unprotected sex, STDs, receiving a blood transfusion prior to 1985 in the United States, having many sex partners, and transmission from a mother to her child.
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Can HIV be Cured Naturally?
HIV stands for human immunodeficiency virus. If someone has HIV it means that they have been diagnosed with the HIV infection. AIDS (acquired immune deficiency syndrome); however, is the most advanced or final stage of the HIV infection. It is important to get tested for HIV in the early stages of infection to minimize the damage to the immune system. Successful treatment aims to reduce HIV load to a level that is harmless to the body.
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How Do You Feel When You Have HIV?
About four weeks after contracting HIV (human immunodeficiency virus), you may experience flu-like symptoms including fever, rash, sore throat, nausea, swollen glands and achy joints. You may remain symptomless for some time, however. That doesn't mean you don't need treatment; HIV can quickly progress into AIDS, in which the immune system collapses and you die of a secondary cancer or infection.
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What Is Usually the First Sign of HIV?
Human immunodeficiency virus (HIV) attacks the cells of the immune system, leading to AIDS and death if left untreated. The first signs of the human immunodeficiency virus infection are flu-like symptoms, which mainly start around two to four weeks after getting HIV. This stage is known as acute HIV infection.
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HIV Medications List and Drug Charts
The ultimate goal of HIV treatment is getting the viral load down below detectable levels. As long as those viral load and antibody levels are below a proscribed range, people with HIV can stave off AIDS and other serious symptoms. Antiviral treatment options usually include combinations of two NRTIs, often referred to as "nucs," and a third drug, typically being a boosted protease inhibitor, a NNRTI, often called "non-nucs," and integrase strand transfer inhibitors.
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HIV/AIDS Infection Transmission and Prevention
HIV (human immunodeficiency virus) is spread through contact with genital fluids or blood of an infected person. The spread of HIV can occur when these secretions come in contact with tissues such as those lining the vagina, anal area, mouth, eyes (the mucus membranes), or with a break in the skin, such as from a cut or puncture by a needle.
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HIV/AIDS Testing: Diagnosis and Monitoring
HIV/AIDS diagnosis and monitoring have come a long way from the days when a diagnosis was a death sentence. Crucial parts of the effective treatment regimens developed in the last 40 years are consistent monitoring of the viral load (the amount of virus in the blood), and the immune cell count, which function as biological markers of the disease’s progression. Doctors also must test for drug resistance.
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HIV/AIDS Facts: What Is HIV?
HIV (human immunodeficiency virus) is the precursor infection to AIDS (acquired immunodeficiency syndrome). HIV is transmitted through blood and genital secretions; most people get it through sexual contact or sharing needles for illegal IV drug use. HIV can be controlled by a strict drug regimen, but left unchecked, it leads to AIDS. In AIDS, the immune system collapses and the body falls prey to secondary, opportunistic infections and cancers that typically kill the person.
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What Are the Side Effects of HIV Medications?
It’s important to know the potential side effects of all the drugs you take to control your HIV infection, as well as potential drug interactions. All of the NNRTIs (nonnucleoside analogue reverse transcriptase inhibitors), for example, are associated with important drug-drug interactions so they must be used with caution in patients on other medications. Learn more about the side effects of the drugs in standard treatment regimens.
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When should you start HIV medication?
Nearly everyone who is infected with HIV (human immunodeficiency virus) should start antiviral medication therapy as soon as they are diagnosed. Older guidelines recommended delaying treatment to help reduce the potential for drug side effects and viral resistance to treatment. Current thinking theorizes that early treatment may preserve more of the body's immune function.
Treatment & Diagnosis
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Medications & Supplements
- Symtuza (darunavir, cobicistat, emtricitabine, and tenofovir alafenamide)
- Genvoya
- Valcyte (valganciclovir hydrochloride)
- Dovato (dolutegravir and lamivudine)
- Prezcobix (darunavir and cobicistat)
- Trogarzo (ibalizumab-uiyk)
- Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide)
- Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate)
- Prezista (darunavir)
- Triumeq (abacavir, dolutegravir, and lamivudine)
- Pifeltro (doravirine)
- Epzicom (abacavir sulfate and lamivudine)
- Mycobutin (rifabutin)
- Side Effects of Trizivir (abacavir, lamivudine, zidovudine)
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