Table of ContentsView AllTable of ContentsBackgroundHow The Drugs WorkDrug ClassesBenefits
Table of ContentsView All
View All
Table of Contents
Background
How The Drugs Work
Drug Classes
Benefits
HAART is the acronym for “highly active antiretroviral therapy,” a term coined in the late 1990s to describe the effectiveness of combination drug therapies used to treatHIV. The term is less commonly used today given that modern antiretrovirals are more than just “highly active” but able to afford people with HIVnear-normal life expectancyand prolonged, disease-free health.
Even so, HAART remains a seminal turning point in the HIV pandemic and the foundation on which modern antiretroviral therapies are built.
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Prior to HAART, the use of one or two antiretroviral drugs afforded limited control of the virus, resulting in rapid treatment failure and the development of multi-drug resistance.
It was with the introduction of a class of drugs calledprotease inhibitorsin 1995 that doctors were able to combine three or more drugs in a way that stopped HIV from replicating at different stages of itslife cycle.
How Antiretrovirals Works
Antiretroviral drugs do not kill HIV; rather, they block different stages in thevirus’s life cycle—from the time it attaches to a cell to the time it creates new copies of itself to infect other cells.
The combination of drugs works as something of a biological “tag team,” suppressing a wide range of HIV variants that can exist within a single population. If one drug is unable to suppress a certain viral type, the others usually can.
By keeping the viral population fully suppressed (undetectable), there are fewer circulating viruses in the bloodstream and fewer opportunities for the virus to mutate into a drug-resistant variant.
What Is a Viral Load and Why Is It Important?
In the past, HAART was equated to triple-drug therapy. Today, because of improved pharmacokinetics, some antiretroviral therapies consist of only two drugs.
There are currently six classes of antiretroviral drugs able to treat HIV, each of which inhibits a specific stage in the virus’s life cycle:
Complete List of Approved HIV Drugs
In addition to preventing disease progression in people with HIV, the widespread use of antiretrovirals can reverse infection rates in many high-risk populations. The strategy, known as treatment as prevention, aims to reduce the “community viral load” within a population, making it more difficult to spread infection.
The same aims can be achieved on an individual level. According to a landmark study published in the May 2019 issue ofThe Lancet,achieving and sustaining an undetectable viral loadreduces the risk of HIV transmission to zero.
With the appropriate precautions, heterosexual couples can evenhave babiessafely when one partner has HIV and the other doesn’t.
Findings like these only punctuate the need for earlytestingandtreatment.
HIV Statistics You Should Know
A Word From Verywell
HAART altered the course of the AIDS pandemic in the late-20th and early-21st centuries. The benefits extended not only to people with HIV but to others around them.
The strategy, known aspre-exposure prophylaxis (PrEP), is currently recommended for people at high risk of infection, including serodiscordant (mixed-status) couples, injecting drug users, and those who engage in protectedanalorvaginal sex.
What Is Considered an Open Wound for HIV Transmission?
14 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.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.0000000000000243Arts EJ, Hazuda DJ.HIV-1 antiretroviral drug therapy.Cold Spring Harb Perspect Med. 2012;2(4):a007161. doi:10.1101/cshperspect.a007161Tseng 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.12403Brady MT, Oleske JM, Williams PL, et al.Declines in mortality rates and changes in causes of death in HIV-1-infected children during the HAART era.J Acquir Immune Defic Syndr. 2010;53(1):86-94. doi:10.1097/QAI.0b013e3181b9869fUNAIDS.90-90-90: An ambitious treatment target to help end the AIDS pandemic.U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.U.S. Food and Drug Administration.FDA-approved HIV medicines.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.Hull M, Lange J, Montaner JS.Treatment as prevention–Where next?.Curr HIV/AIDS Rep. 2014;11(4):496-504. doi:10.1007/s11904-014-0237-5Rodger A., Cambiano V, Bruun T, et al.Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.Lancet.2019 May 2; pii: S0140-6736(19)30418-0. doi:10.1016/S0140-6736(19)30418-0The INSIGHT START Study Group.Initiation of antiretroviral therapy in early asymptomatic HIV infection.N Engl J Med. 2015 Aug;373:795-807. doi:10.1056/NEJMoa1506816Centers for Disease Control and Prevention.Pre-exposure prophylaxis (PrEP).HIV.gov.Pre-exposure prophylaxis (PrEP).
14 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.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.0000000000000243Arts EJ, Hazuda DJ.HIV-1 antiretroviral drug therapy.Cold Spring Harb Perspect Med. 2012;2(4):a007161. doi:10.1101/cshperspect.a007161Tseng 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.12403Brady MT, Oleske JM, Williams PL, et al.Declines in mortality rates and changes in causes of death in HIV-1-infected children during the HAART era.J Acquir Immune Defic Syndr. 2010;53(1):86-94. doi:10.1097/QAI.0b013e3181b9869fUNAIDS.90-90-90: An ambitious treatment target to help end the AIDS pandemic.U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.U.S. Food and Drug Administration.FDA-approved HIV medicines.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.Hull M, Lange J, Montaner JS.Treatment as prevention–Where next?.Curr HIV/AIDS Rep. 2014;11(4):496-504. doi:10.1007/s11904-014-0237-5Rodger A., Cambiano V, Bruun T, et al.Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.Lancet.2019 May 2; pii: S0140-6736(19)30418-0. doi:10.1016/S0140-6736(19)30418-0The INSIGHT START Study Group.Initiation of antiretroviral therapy in early asymptomatic HIV infection.N Engl J Med. 2015 Aug;373:795-807. doi:10.1056/NEJMoa1506816Centers for Disease Control and Prevention.Pre-exposure prophylaxis (PrEP).HIV.gov.Pre-exposure prophylaxis (PrEP).
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.
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.0000000000000243Arts EJ, Hazuda DJ.HIV-1 antiretroviral drug therapy.Cold Spring Harb Perspect Med. 2012;2(4):a007161. doi:10.1101/cshperspect.a007161Tseng 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.12403Brady MT, Oleske JM, Williams PL, et al.Declines in mortality rates and changes in causes of death in HIV-1-infected children during the HAART era.J Acquir Immune Defic Syndr. 2010;53(1):86-94. doi:10.1097/QAI.0b013e3181b9869fUNAIDS.90-90-90: An ambitious treatment target to help end the AIDS pandemic.U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.U.S. Food and Drug Administration.FDA-approved HIV medicines.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.Hull M, Lange J, Montaner JS.Treatment as prevention–Where next?.Curr HIV/AIDS Rep. 2014;11(4):496-504. doi:10.1007/s11904-014-0237-5Rodger A., Cambiano V, Bruun T, et al.Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.Lancet.2019 May 2; pii: S0140-6736(19)30418-0. doi:10.1016/S0140-6736(19)30418-0The INSIGHT START Study Group.Initiation of antiretroviral therapy in early asymptomatic HIV infection.N Engl J Med. 2015 Aug;373:795-807. doi:10.1056/NEJMoa1506816Centers for Disease Control and Prevention.Pre-exposure prophylaxis (PrEP).HIV.gov.Pre-exposure prophylaxis (PrEP).
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
Arts EJ, Hazuda DJ.HIV-1 antiretroviral drug therapy.Cold Spring Harb Perspect Med. 2012;2(4):a007161. doi:10.1101/cshperspect.a007161
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
Brady MT, Oleske JM, Williams PL, et al.Declines in mortality rates and changes in causes of death in HIV-1-infected children during the HAART era.J Acquir Immune Defic Syndr. 2010;53(1):86-94. doi:10.1097/QAI.0b013e3181b9869f
UNAIDS.90-90-90: An ambitious treatment target to help end the AIDS pandemic.
U.S. Food and Drug Administration.FDA approves first two-drug complete regimen for HIV-infected patients who have never received antiretroviral treatment.
U.S. Food and Drug Administration.FDA-approved HIV medicines.
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.
Hull M, Lange J, Montaner JS.Treatment as prevention–Where next?.Curr HIV/AIDS Rep. 2014;11(4):496-504. doi:10.1007/s11904-014-0237-5
Rodger A., Cambiano V, Bruun T, et al.Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.Lancet.2019 May 2; pii: S0140-6736(19)30418-0. doi:10.1016/S0140-6736(19)30418-0
The INSIGHT START Study Group.Initiation of antiretroviral therapy in early asymptomatic HIV infection.N Engl J Med. 2015 Aug;373:795-807. doi:10.1056/NEJMoa1506816
Centers for Disease Control and Prevention.Pre-exposure prophylaxis (PrEP).
HIV.gov.Pre-exposure prophylaxis (PrEP).
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