Courtesy of Education Subcommittee of the Patient Care
Committee of the Adult AIDS Clinical Trials Group
An antiretroviral (ARV) is not a cure for HIV; it only slows
the disease’s progress. Therefore, even when taking ARVs, you
must consider yourself infectious, and you must take your ARV
exactly as prescribed.
An ARV is any medication that acts directly on HIV to keep
it from reproducing. There are currently five kinds of ARVs
that differ in where they act in the reproductive cycle:
- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Non-nucleoside reverse transcriptase inhibitors
(NNRTIs)
- Protease inhibitors (PIs)
- Fusion inhibitors (FIs)
- Interleuken inhibitors (IIs)
They all have different ways of doing the same thing:
keeping the virus from making more copies of itself.
Reverse transcriptase inhibitors (RTIs)
prevent the virus from making more copies of its genetic
material. This keeps it from making the rest of the proteins
and sugars needed to build more copies. There are two types:
nucleoside (RTIs) and non-nucleoside (NNRTIs).
RTIs are inserted in the growing genetic material and act as
a block to prevent finishing the construction process. RTIs
include drugs like AZT, ddC, ddI, D4T, 3TC, and 1592. NNRTIs
bind to the enzyme Reverse Transcriptase to keep it from
building the genetic material. NNRTIs include drugs like
delavirdine, nevirapine and Efavirenz.
Protease inhibitors block the HIV protease
enzyme from breaking apart long chains or proteins and sugars
into the smaller pieces needed to build a new virus. Drugs in
this class include saquinavir, ritonavir, indinavir, nelfinavir
and VX-478.
By preventing the virus from reproducing, we hope to halt
the destruction of your immune system that HIV causes. Another
point to remember is ARVs do not kill the virus! As long as you
take your medications exactly as prescribed, the damage already
done to your immune system can be slowed. "Can be" is very
important here because we don't know exactly how long any ARV
taken properly will work. That will vary from person to person,
and there is no way to predict that at the moment.
In addition to bringing a medical benefit, the ARVs have
many side effects. This is not peculiar to the
ARVs; all medications have side effects. Unfortunately the side
effects of ARVs may be more dramatic than with other
medications. Most of these side effects are manageable by
changing your dose. Sometimes another medication might be
prescribed to treat the side effect. It all depends on the side
effect and your physician's assessment of your problem.
So please keep in mind the following:
- ARVs are treatments, not cures. A cure would eliminate
the virus from the body. At best, ARVs only slow the disease
process.
- Because ARVs are only treatments, you must consider
yourself infectious. It is still possible for you to transfer
the virus to other people by sexual contact, sharing IV
needles or through child birth or breast feeding. If you have
any questions about the chances of giving AIDS to someone
else, talk to your doctor, nurse or pharmacist.
- Take your ARV exactly as prescribed. Do not change your
dose or stop taking it on your own, even if you are having
side effects. If someone other than the clinic staff suggests
changing your dose, check with the clinic before doing
so.
