The acronym cART stands for “combination antiretroviral therapy.” It refers to the combinations of drugs that are used to keepHIV infectionsunder control.While combination HIV therapies have historically been referred to asHAART(highly active antiretroviral therapy), the terminology has evolved to where many people simply described it as cART or ART (antiretroviral therapy).
As confusing as these changes may seem, they are about more than just semantics.
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What Is Antiretroviral Therapy?
Without the means to complete the cycle, HIV cannot generate new copies of itself and the number of viral particles will quickly drop, ideally to undetectable levels.
Types of Antiretroviral Drugs
There are seven major classes ofantiretroviral drugs, each of which interferes with replication in different ways:
List of Approved HIV Antiretroviral Drugs
From HAART to cART
The term HAART was coined in 1996 with the introduction of the first triple-drug therapies that were able to fully control the virus and prevent disease progression.It was a landmark moment that cemented the term “HAART” in both the medical community’s and the public’s consciousness.
Even so, the antiretroviral drugs of that era were prone to severe side effects that some people found intolerable. Others required complex dosing schedules with multiple drugs taken at different hours, while others still could develop drug resistance quickly, leading to treatment failure and the loss of treatment options.
With the introduction of Viread (tenofovir disoproxil fumarate) in 2001 and Truvada (tenofovir disoproxil fumarate + emtricitabine) in 2004, the picture quickly changed. These novel NRTIs could overcome a multitude of drug-resistant mutations, even in people with deep resistance and few treatment options left.
With the subsequent release of newer classes of drugs, including theintegrase inhibitorsused today in the first-line treatment of HIV, people were no longer faced with the same concerns of the past. Combination therapies were now more durable, had fewer severe side effects, and required as few as one pill per day.
By this time, many in the medical community began to question whether “highly effective” was an appropriate moniker, given that people with HIV could now enjoynormal to near-normal life expectancywith a significant reduction in severe HIV-related illnesses.
From cART to ART
The advances in antiretroviral therapy in the last decade have been nothing short of astonishing.
Whereas, in the past, the term HAART inferred three drugs and cART could consist of up to four—such as the fixed-dose combination drug Stribild (tenofovir disoproxil fumarate + emtricitabine + elvitegravir + cobicistat)—scientists today have improved the pharmacokinetics of newer antiretrovirals so that fewer drugs or doses are needed.
Around the same time, researchers were able to create a “better” version of Viread, called tenofovir alafenamide (TAF), which was just as effective but dramatically reduced the risk of kidney- and bone-related side effects.What followed was a veritable cavalcade of new drug releases, including an “improved” version of Stribild calledGenvoyaand four other combination drugs containing TAF.
By 2021, scientists transformed the definition of “cART” from drugs you take daily to ones that may only need to be taken monthly.
In January 2021, the FDA approved Cabenuva (cabotegravir and rilpivirine), a combination injectable antiretroviral therapy that is given monthly or every two months to suppress HIV effectively.
With the sea change in treatment options, many in the medical community no longer feel the need to qualify antiretroviral therapy, abandoning even “cART” for a more straightforward “ART.”
Is HIV Curable?
A Word From Verywell
You may continue to see all three terms—HAART, cART, and ART—in medical literature and online. Don’t let this confuse you; they all mean the same thing. What is most important is understanding the benefits of antiretroviral therapy and seeking appropriatetreatmentif youtest positivefor the virus.
How to Know If You Have HIV
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bhatti AB, Usman M, Kandi V.Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy.Cureus. 2016;8(3):e515. doi:10.7759/cureus.515Tseng A, Seet J, Phillips EJ.The evolution of three decades of antiretroviral therapy: challenges, triumphs and the promise of the future.Br J Clin Pharmacol. 2015 Feb;79(2):182-94. doi:10.1111/bcp.12403May MT, Gompels M, Delpech V, et al.Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy.AIDS. 2014;28(8):1193-202. doi:10.1097/QAD.0000000000000243U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.Sampath R, Zeuli J, Rizza S, Temesgen Z.Tenofovir alafenamide fumarate for the treatment of HIV infection.Drugs Today (Barc). 2016 Nov;52(11):617-25. doi:10.1358/dot.2016.52.11.2546852Food and Drug Administration.Cabenuva label.U.S. Food and Drug Administration.FDA approves first extended-release, injectable drug regimen for adults living with HIV.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bhatti AB, Usman M, Kandi V.Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy.Cureus. 2016;8(3):e515. doi:10.7759/cureus.515Tseng A, Seet J, Phillips EJ.The evolution of three decades of antiretroviral therapy: challenges, triumphs and the promise of the future.Br J Clin Pharmacol. 2015 Feb;79(2):182-94. doi:10.1111/bcp.12403May MT, Gompels M, Delpech V, et al.Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy.AIDS. 2014;28(8):1193-202. doi:10.1097/QAD.0000000000000243U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.Sampath R, Zeuli J, Rizza S, Temesgen Z.Tenofovir alafenamide fumarate for the treatment of HIV infection.Drugs Today (Barc). 2016 Nov;52(11):617-25. doi:10.1358/dot.2016.52.11.2546852Food and Drug Administration.Cabenuva label.U.S. Food and Drug Administration.FDA approves first extended-release, injectable drug regimen for adults living with HIV.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bhatti AB, Usman M, Kandi V.Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy.Cureus. 2016;8(3):e515. doi:10.7759/cureus.515Tseng A, Seet J, Phillips EJ.The evolution of three decades of antiretroviral therapy: challenges, triumphs and the promise of the future.Br J Clin Pharmacol. 2015 Feb;79(2):182-94. doi:10.1111/bcp.12403May MT, Gompels M, Delpech V, et al.Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy.AIDS. 2014;28(8):1193-202. doi:10.1097/QAD.0000000000000243U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.Sampath R, Zeuli J, Rizza S, Temesgen Z.Tenofovir alafenamide fumarate for the treatment of HIV infection.Drugs Today (Barc). 2016 Nov;52(11):617-25. doi:10.1358/dot.2016.52.11.2546852Food and Drug Administration.Cabenuva label.U.S. Food and Drug Administration.FDA approves first extended-release, injectable drug regimen for adults living with HIV.
Bhatti AB, Usman M, Kandi V.Current scenario of HIV/AIDS, treatment options, and major challenges with compliance to antiretroviral therapy.Cureus. 2016;8(3):e515. doi:10.7759/cureus.515
Tseng A, Seet J, Phillips EJ.The evolution of three decades of antiretroviral therapy: challenges, triumphs and the promise of the future.Br J Clin Pharmacol. 2015 Feb;79(2):182-94. doi:10.1111/bcp.12403
May MT, Gompels M, Delpech V, et al.Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy.AIDS. 2014;28(8):1193-202. doi:10.1097/QAD.0000000000000243
U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.
Sampath R, Zeuli J, Rizza S, Temesgen Z.Tenofovir alafenamide fumarate for the treatment of HIV infection.Drugs Today (Barc). 2016 Nov;52(11):617-25. doi:10.1358/dot.2016.52.11.2546852
Food and Drug Administration.Cabenuva label.
U.S. Food and Drug Administration.FDA approves first extended-release, injectable drug regimen for adults living with HIV.
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