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As of 2022, the Food and Drug Administration has approved 26 individual drug agents and 22 fixed-dosed combination (FDC) drugs comprised of two or more antiretrovirals.This includes the first antiretroviral drug regimen, Cabenuva, which requires a once-a-month or once-every-two-month injection rather than an oral dose daily.
Antiretroviral therapyis quickly changing, with newer drug agents offering fewer side effects, greater durability, and a decreased risk of drug resistance. In the past, antiretroviral therapy was described as a three-drug “cocktail.” Today, with improved pharmacokinetics and a longerdrug half-life, antiretroviral therapy may involve as few as two co-formulated drug agents.
While several new antiretroviral drugs have been added to the treatment arsenal since 2010, older ones like Crixivan (indinavir), Rescriptor (delavirdine), Videx (didanosine), Viracept (nelfinavir), and Zerit (stavudine) have been discontinued and are no longer in use.
How HIV Is Treated
Entry/Attachment Inhibitors
Integrase Inhibitors
HIV Statistics You Should Know
Nucleoside Reverse Transcriptase Inhibitors
In order for HIV to replicate, it uses an enzyme called reverse transcriptase to translate its viral RNA into double-strandedDNA, which is then integrated into the nucleus of the host cell to “hijack” its genetic machinery. By doing so, HIV can begin to churn out multiple copies of itself.
Nucleoside reverse transcriptase inhibitors (NRTIs) block the action of reverse transcriptase and so prevent the replication of the virus.
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Non-Nucleoside Reverse Transcriptase Inhibitors
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) also block reverse transcriptase but in a different way. Rather than attaching to viral DNA like NRTIs do, NNRTIs bind directly to the enzyme, blocking its action.
Protease Inhibitors
List of Approved HIV Antiretroviral Drugs
Pharmacokinetic Enhancers
Also called HIV boosters, these drugs are used to “boost” the concentration of protease inhibitors in the bloodstream. Without them, the concentration of the accompanying PI would quickly fall beneath the therapeutic level, providing the virus an opportunity to replicate.
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Capsid Inhibitors
Capsid inhibitors disrupt the HIV capsid, a protective protein shell for HIV’s genetic material and replication enzymes. These inhibitors can interfere with the HIV capsid at various stages of the viral life cycle.
Fixed-Dose Combination Drugs
Fixed-dose combination drugs reduce the daily pill burden a person with HIV may otherwise be faced with when undergoing antiretroviral therapy. Some FDC drugs are used with other antiretroviral agents. Others are entirely used on their own.
Of the 22 FDC drugs approved for use in the United States, 14 are all-in-one treatments taken once daily.
11 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.HIVinfo.NIH.gov.FDA-approved HIV medications.ViiV Healthcare.Cabenuva.Soriano V, Fernandez-Montero JV, Benitez-Gutierrez L, et al.Dual antiretroviral therapy for HIV infection.Expert Opin Drug Saf. 2017;16(8):923-932. doi:10.1080/14740338.2017.1343300International Association of Providers of AIDS Care.How entry inhibitors work.Hajimahdi Z, Zarghi A.Progress in HIV-1 integrase inhibitors: a review of their chemical structure diversity.Iran J Pharm Res. 2016;15(4):595-628.National Institutes of Health Office of Aids Research.Nucleoside Reverse Transcriptase Inhibitor (NRTI).National Institutes of Health Office of Aids Research.Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI).Siberry GK.Management of HIV infection.Principles and Practice of Pediatric Infectious Diseases. Elsevier; 2018:681-689.e2. doi:10.1016/B978-0-323-40181-4.00113-4National Institutes of Health Office of Aids Research.Pharmacokinetic Enhancers.National Institutes of Health Office of AIDS Research.Capsid Inhibitors.Bor J, Kluberg SA, LaValley MP, et al.One pill, once a day: simplified treatment regimens and retention in HIV care.Am J Epidemiol. 2022;191(6):999-1008. doi:10.1093/aje/kwac006
11 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.HIVinfo.NIH.gov.FDA-approved HIV medications.ViiV Healthcare.Cabenuva.Soriano V, Fernandez-Montero JV, Benitez-Gutierrez L, et al.Dual antiretroviral therapy for HIV infection.Expert Opin Drug Saf. 2017;16(8):923-932. doi:10.1080/14740338.2017.1343300International Association of Providers of AIDS Care.How entry inhibitors work.Hajimahdi Z, Zarghi A.Progress in HIV-1 integrase inhibitors: a review of their chemical structure diversity.Iran J Pharm Res. 2016;15(4):595-628.National Institutes of Health Office of Aids Research.Nucleoside Reverse Transcriptase Inhibitor (NRTI).National Institutes of Health Office of Aids Research.Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI).Siberry GK.Management of HIV infection.Principles and Practice of Pediatric Infectious Diseases. Elsevier; 2018:681-689.e2. doi:10.1016/B978-0-323-40181-4.00113-4National Institutes of Health Office of Aids Research.Pharmacokinetic Enhancers.National Institutes of Health Office of AIDS Research.Capsid Inhibitors.Bor J, Kluberg SA, LaValley MP, et al.One pill, once a day: simplified treatment regimens and retention in HIV care.Am J Epidemiol. 2022;191(6):999-1008. doi:10.1093/aje/kwac006
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.
HIVinfo.NIH.gov.FDA-approved HIV medications.ViiV Healthcare.Cabenuva.Soriano V, Fernandez-Montero JV, Benitez-Gutierrez L, et al.Dual antiretroviral therapy for HIV infection.Expert Opin Drug Saf. 2017;16(8):923-932. doi:10.1080/14740338.2017.1343300International Association of Providers of AIDS Care.How entry inhibitors work.Hajimahdi Z, Zarghi A.Progress in HIV-1 integrase inhibitors: a review of their chemical structure diversity.Iran J Pharm Res. 2016;15(4):595-628.National Institutes of Health Office of Aids Research.Nucleoside Reverse Transcriptase Inhibitor (NRTI).National Institutes of Health Office of Aids Research.Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI).Siberry GK.Management of HIV infection.Principles and Practice of Pediatric Infectious Diseases. Elsevier; 2018:681-689.e2. doi:10.1016/B978-0-323-40181-4.00113-4National Institutes of Health Office of Aids Research.Pharmacokinetic Enhancers.National Institutes of Health Office of AIDS Research.Capsid Inhibitors.Bor J, Kluberg SA, LaValley MP, et al.One pill, once a day: simplified treatment regimens and retention in HIV care.Am J Epidemiol. 2022;191(6):999-1008. doi:10.1093/aje/kwac006
HIVinfo.NIH.gov.FDA-approved HIV medications.
ViiV Healthcare.Cabenuva.
Soriano V, Fernandez-Montero JV, Benitez-Gutierrez L, et al.Dual antiretroviral therapy for HIV infection.Expert Opin Drug Saf. 2017;16(8):923-932. doi:10.1080/14740338.2017.1343300
International Association of Providers of AIDS Care.How entry inhibitors work.
Hajimahdi Z, Zarghi A.Progress in HIV-1 integrase inhibitors: a review of their chemical structure diversity.Iran J Pharm Res. 2016;15(4):595-628.
National Institutes of Health Office of Aids Research.Nucleoside Reverse Transcriptase Inhibitor (NRTI).
National Institutes of Health Office of Aids Research.Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI).
Siberry GK.Management of HIV infection.Principles and Practice of Pediatric Infectious Diseases. Elsevier; 2018:681-689.e2. doi:10.1016/B978-0-323-40181-4.00113-4
National Institutes of Health Office of Aids Research.Pharmacokinetic Enhancers.
National Institutes of Health Office of AIDS Research.Capsid Inhibitors.
Bor J, Kluberg SA, LaValley MP, et al.One pill, once a day: simplified treatment regimens and retention in HIV care.Am J Epidemiol. 2022;191(6):999-1008. doi:10.1093/aje/kwac006
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