Therapies for Treating HIV and its Affects…

Classes of Drugs

There are six classifications of anti-HIV drugs - referred to as antiretroviral drugs.

The drugs are classified based on the stage of the HIV life cycle that they target. Ultimately, they are doing the same thing - prevent the virus from making new copies of itself - but they do it in different ways. 2007 brought us two new drug classes: the CCR5 antagonists (a type of entry inhibitor) and the integrase inhibitors.

With few exceptions, most anti-HIV therapies include drugs from at least two classes, because attacking the virus with drugs that work in different ways has shown to be the most effective way to help prevent drug resistance. The traditional combinations, especially for people just starting therapy, have combined nucleoside analog reverse transcriptase inhibitors (NRTIs) plus either a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI). As more classes become available, we’ll begin to see the emergence of new approaches and more options for therapy.

• Nucleoside & nucleotide reverse transcriptase inhibitors (NRTI) prevent viral RNA from converting to the viral DNA that infects healthy cells. The NNRTIs, or “non-nukes,” are powerful drugs with little long-term toxicity. Side effects occur early on, usually in the first few weeks. Resistance to NNRTIs can occur easily and quickly if the viral load isn’t suppressed.

• Non-nucleoside reverse transcriptase inhibitors (nNRTI) bind to the transcriptase enzyme and interfere with its function of turning HIV RNA into DNA. NRTIs or “Nukes” were the only drugs we had until 1996, and they’ve been components of just about every drug regimen since the approval of Retrovir (AZT) in the mid-80’s.

• Protease inhibitors (PIs) stop HIV replication by keeping the enzyme protease from cutting the virus into the shorter pieces that it needs to make copies of itself. Incomplete, defective copies are formed which can't infect cells. The PIs are the drugs that changed everything. The combination of NRTIs plus PIs first allowed us to completely suppress HIV viral load. Suddenly, doctors could do more than just temporarily boost the CD4 count for a few years. HIV infection quickly went from being a progressive fatal disease to one that was chronic and manageable.

• Entry inhibitors block HIV’s ability to enter into CD4 cells. These drugs stop the process before HIV even has a chance to insert its material into healthy cells. There are several stages of viral entry.
  • First is attachment of the virus to the CD4 receptor. There aren’t any attachment inhibitors available yet, so this is a potential target for drug development.
  • Next, the virus binds to a target on the cell (either CCR5 or CXCR4). This year, the FDA approved the first CCR5 antagonist.
  • Finally, HIV fuses with the membrane of the CD4 cell, a step blocked by Fuzeon, a fusion inhibitor

• Integrase inhibitors, the newest class of drugs, block the insertion of HIV DNA into human DNA.

AIDS Research Alliance has researched treatments aimed at

• Opportunistic Infections examples which usually occur once a person’s T-cell counts have dropped below 200 and they have progressed from HIV to AIDS, and

Opportunistic Infections include

• Bacterial Infections like Diarrhea (Salmonellosis, Campylobacteriosis, Shigellosis), Pneumonia or Tuberculosis (TB)
• Malignancies like Anal or Cervical Cancers, Kaposi's Sarcoma (KS) or Lymphomas
• Viral Infections like Cytomegalovirus (CMV), Hepatitis C, Herpes Simplex Virus (oral & genital herpes) or Human Papilloma Virus (HPV, genital warts)
• Fungal Infections like Aspergillosis, Candidiasis (thrush, yeast infection), or Cryptococcal Meningitis
• Protozoan Infections like Cryptosporidiosis, Isosporiasis, Microsporidiosis, Pneumocystis Pneumonia (PCP) or Toxoplasmosis
• Neurological Conditions like AIDS Dementia Complex
• Other Conditions and Complications like Canker Sores, Thrombocytopenia (low platelets) or Wasting Syndrome

• Metabolic Disorders examples which are problems with any of the processes of build up, break down or excretion of substances in the body that can occur as a side effect of anti-HIV medication or from having HIV itself.

  Metabolic Disorders include:

  • Neurological Conditions like AIDS Dementia Complex (ADC), Peripheral Neuropathy
  • Fat distribution abnormalities, which can lead to dyslipidemia, insulin resistance, diabetes mellitus, obesity, and
  • Increased risk of cardiovascular disease. Cardiovascular disease is now a leading cause of death among HIV-infected patients.
  • Lipid abnormalities include elevated triglycerides and elevated total cholesterol (TC).

View our currently enrolling Clinical Trials

Complementary Treatments

Many people use complementary (sometimes known as alternative) health treatments to go along with the medical care they get from their doctor.

With most complementary therapies, your health is viewed from a holistic (or "whole picture") point of view. Think of your body as working as one big system. From a holistic viewpoint, everything you do - from the foods you eat or things you drink to the amount of stress you have - affects your health and well-being.

Many people - with or without HIV - use these kinds of therapies to try to make their immune systems stronger and to make themselves feel better in general. Some HIV+ people also use these therapies to help deal with symptoms of the disease or side effects from the medicines that treat the disease.

These treatments include:

• Herbal medicine, nutritional supplements
• Physical therapies, such as yoga, massage and acupuncture
• Relaxation techniques like meditation and visualization

While many people report positive results from using complementary therapies, in most cases, there is not enough research to confirm if these treatments really help people with HIV. A growing number of researchers - including our team at AIDS Research Alliance - have conducted a number of studies on complementary therapies in our search for better disease management. ARA has turned its clinical focus on such therapies as micronutrients and pomegranate juice .View our currently enrolling Clinical Trials

This information is provided as a quick reference only. Always discuss medication concerns with your physician. Remember to always take medications exactly as prescribed and not to change or stop your medications without first speaking with your physician.