MD - General Medicine
HIV treatment is done by antiviral drugs, there are number of antiviral drugs available in the market, usually HIV is treated with combination of drugs, usually two to three drugs are used in treating HIV in initial stage, we can change the combination of drugs according to requirement of the patient. Drugs can be adjusted or increased if there is resistance of HIV in the patient.
There are number of compounds (about 22 in number) which have been formally approved (by the us food and drug administration) for the treatment of HIV infections (aids). According to their point of intervention with the HIV replicative cycle, these compounds can be classified in 5 categories:
1. NRTIs (Nucleoside Reverse Transcriptase Inhibitors): Azidothymidine, Didanosine, Zalcitabine, Stavudine, Lamivudine, Abacavir and Emtricitabine, Tenofovir, administered as its oral pro drug form TDF (Tenofovir Disoproxil Fumarate)
2. NNRTIs (Non-Nucleoside Reverse Transcriptase Inhibitors): Nevirapine, Delavirdine and Efavirenz
3. PIs (Protease Inhibitors HIV): Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir, Lopinavir, Atazanavir, Fosamprenavir, Tipranavir and Darunavir
4. FIs (Fusion inhibitors): Enfuvirtide. Starting from the drugs which are currently available for the treatment of aids, numerous combinations could be envisaged. Drug combinations are, in principle, aimed at obtaining synergism between the compounds (reasonably expected if they act by different mechanisms), while reducing the likelihood for drug resistance development. Such anti-HIV drug combination regimes were initiated about 10 years ago and have been generally referred to as haart (for highly active antiretroviral therapy). While haart originally consisted of a pill burden of twenty (or more) pills per day, this has been gradually diminished over the past few years, and, since July 2006, a all-in-one pill (teevir from myelin and virotrenz from ranbaxy sun pharma) has become available, which contains three anti-hiv drugs (tenofovir disoproxil fumarate 300 mg, emtricitabine 200mg and efavirenz 600 mg) to be taken as a single pill only once daily. Given the information that has been acquired on the therapeutic use (efficacy, safety) of tenofovir disoproxil fumarate over the past five years, it would now seem mandatory to further consider the prophylactic use of TDF [and its combination with emtricitabine (truvada) and/or atripla], as a single daily pill to prevent HIV infection. New combinations of drugs are also available which include tenofovir 300 mg lamivudine 150 mg which are very new drugs.