- Earlier development of drug resistance
- Transmission of drug-resistant virus
- Limitation in future choices of antiretroviral agents as a result of develop-
ment of resistance - Unknown longterm toxicity of antiretroviral drugs
- Unknown duration of effectiveness of current antiretroviral therapies
HIV medication
There are four classes of medication approved by the FDA for treatment of HIV
(see Charts). These are:
Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)NNRTIs bind to reverse transcriptase, a protein HIV needs to make more copies
of itself. In doing so, reverse transcriptase becomes disabled. Drugs within this
category include Delavirdine (Rescriptor, DLV), Efavirenz (Sustiva, EFV), and
Neviapine (Viramune, NVP).
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)NRTIs are faulty version reverse transcriptase. Reproduction of HIV is stalled
when HIV uses NRTI instead of the normal reverse transcriptase. Drugs within
this category include Abacavir (Ziagen, ABC), Abacavir, Lamivudine (Epzicom),
Abacavir, Lamivudine, Zidovudine (Trizivir), Didanosine (Videx, ddI, Videx
EC), Emtricitabine (Emtriva, FTC, Coviracil), Emtricitabine, Tenofovir DF
(Truvada), Lamivudine (Epivir, 3TC), Lamivudine, Zidovudine (Combivir),
Stavudine (Zerit, d4T), Tenofovir DF (Viread, TDF), Zalcitabine (Hivid, ddC),
and Zidovudine (Retrovir, AZT, AZV).
Protease Inhibitors (PIs)PI disables protease, a protein that HIV needs to make more copies of itself.
Drugswithin this category include Amprenavir (Agenerase, APV), Atazanavir
(Reyataz, ATV), Fosamprenavir (Lexiva, FPV), Indinavir (Crixivan, IDV),
Lopinavir, Ritonavir (Kaletra, LPV/r), Nelvinavir (Viracept, NFV), Ritonavir,
(Norvir, RTV), and Saquinavir (Fortovase, SQV; Invirase).
Fusion InhibitorsFusion Inhibitors prevent HIV from entry into cells. They include Enfuviritide
(Fuzeon, T-20).
CHAPTER 17 Immunologic Agents^319