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HIV and AIDS: Antiretroviral Drugs, Treatments and Medications

While the cure for AIDS may be many years off, continued clinical research results in HIV treatment advances. As HIV/AIDS research lends itself to greater HIV education and AIDS awareness, new medications are developed to help patients living with HIV and AIDS lead longer, stronger lives. Treatments and medications for HIV/AIDS are organized into the following categories:

Entry Inhibitors (including Fusion Inhibitors) and CCR5 Co-receptor Antagonist

Entry Inhibitors
Entry inhibitors block HIV entry into CD4+ cells.

Fusion inhibitors
The only drug in this class is T-20, which is administered as a twice daily subcutaneous injection. The most common side effect is redness and pain at the site of injection. Rarely, infection can occur at the injection site. There also are reports of generalized allergic reactions.

CCR5 antagonist
Although there were some early concerns of liver inflammation for drugs in this class, MVC appeared to be well tolerated in clinical trials without any specific toxicities attributable to the drug. However, it is a new drug in a new class and the first to actually target the cell. For these reasons, longer follow-up from clinical trials and those followed in the clinic will be very important for assessing the overall safety of the drug.

Brand Name Generic Names Manufacturer
Selzentry maraviroc Pfizer
Fuzeon enfuvirtide, T-20 Hoffmann-La Roche & Trimeris

HIV Integrase Strand Transfer Inhibitors

The first available drug in this class is RAL and represents a new drug in a new class that appears to be very potent at suppressing HIV in all patients who have never been on this drug or other integrase inhibitors in development. It was initially approved for treatment-experienced patients with drug-resistant virus. It is also now approved for those starting therapy for the first time. The approved dose of RAL is 400 mg twice daily.

Brand Name Generic Name Manufacturer
Isentress raltegravir Merck & Co., Inc.

Multi-Class Combination Drugs

Multi-class combination drugs are comprised of components of other antiretroviral drugs into a single pill.

Brand Name Generic Names Manufacturer
Atripla efavirenz, emtricitabine and tenofovir disoproxil fumarate Bristol-Myers Squibb and Gilead Sciences

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Like NRTIs, NNRTIs block the reverse transcriptase enzyme preventing uninfected cells from becoming infected.

NNRTIs include NVP, DLV, EFV and the recently approved etravirine (Intelence, ETR). ETR was developed specifically to be an option for patients that have developed resistance to the earlier drugs in the class. NVP, DLV, and EFV are typically used with two NRTIs, and ETR is primarily being used as part of regimens for those with a history of different types of treatment to which they have developed resistance.

Brand Name Generic Names Manufacturer
Intelence etravirine Tibotec Therapeutics
Rescriptor delavirdine, DLV Pfizer
Sustiva efavirenz, EFV Bristol Myers-Squibb
Viramune nevirapine, NVP Boehringer Ingelheim

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

NRTIs block an enzyme of the HIV called reverse transcriptase that allows HIV to infect human cells, particularly CD4 T cells or lymphocytes. Reverse transcriptase converts HIV genetic material, which is RNA, into human genetic material, which is DNA. The human-like DNA of HIV then becomes part of the infected person's own cells, allowing the cell to produce RNA copies of the HIV that can then go on to attack other not yet infected cells. Thus, blocking reverse transcriptase prevents HIV from taking over (infecting) human cells.

Brand Name Generic Names Manufacturer
Combivir lamivudine and zidovudine GlaxoSmithKline
Emtriva emtricitabine, FTC Gilead Sciences
Epivir lamivudine, 3TC GlaxoSmithKline
Epzicom abacavir and lamivudine GlaxoSmithKline
Hivid zalcitabine, dideoxycytidine, ddC Hoffmann-La Roche
Retrovir zidovudine, azidothymidine, AZT, ZDV GlaxoSmithKline
Trizivir abacavir, zidovudine, and lamivudine GlaxoSmithKline
Truvada tenofovir disoproxil fumarate and emtricitabine tenofovir disoproxil fumarate and emtricitabine
Videx EC enteric coated didanosine, ddI EC Bristol Myers-Squibb
Videx didanosine, dideoxyinosine, ddI Bristol Myers-Squibb
Viread tenofovir disoproxil fumarate, TDF Gilead
Zerit stavudine, d4T Bristol Myers-Squibb
Ziagen abacavir sulfate, ABC GlaxoSmithKline

Protease Inhibitors (PIs)

PIs block the action of an HIV enzyme called protease that allows HIV to produce infectious copies of itself within HIV-infected human cells. Thus, blocking protease prevents HIV in already-infected cells from producing HIV that can infect other, not yet infected cells.

Brand Name Generic Names Manufacturer
Agenerase (discontinued) amprenavir, APV GlaxoSmithKline
Aptivus tipranavir, TPV Boehringer Ingelheim
Crixivan indinavir, IDV Merck
Invirase saquinavir mesylate, SQV Hoffmann-La Roche
Kaletra lopinavir and ritonavir, LPV/RTV Abbott Laboratories
Lexiva Fosamprenavir Calcium, FOS-APV GlaxoSmithKline
Norvir ritonavir, RTV Abbott Laboratories
Prezista darunavir Tibotec, Inc.
Reyataz atazanavir sulfate, ATV Bristol-Myers Squibb
Viracept nelfinavir mesylate, NFV Agouron Pharmaceuticals

SOURCES:
The U.S. Food and Drug Administration

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