University of California San Francisco | About UCSF | UCSF Benioff Children's Hospital San Francisco
Search Site | Find a Doctor

HIV
Treatment

At this time, there is no cure for HIV or AIDS, but medications are effective in fighting HIV and its complications. Treatments are designed to reduce HIV in your body, keep your immune system as healthy as possible and decrease the complications you may develop.

You and your doctor will work together to develop a treatment plan that best meets your needs. Three main factors will be considered when designing your treatment plan:

  • Your willingness and readiness to begin therapy
  • The stage of your disease
  • Other health problems

The U.S. Food and Drug Administration (FDA) has approved a number of drugs for treating HIV and AIDS.

It's important that you take your medications exactly as prescribed. This is a crucial part of your treatment success. Our program offers pharmacy services to help you maintain your drug regimen and to answer any questions you may have.

Most medications have side effects, which your doctor will discuss with you. Individuals respond differently to medications and side effects may vary. Our doctors, nurses and pharmacists can help you manage these side effects.

AIDS Medications

Although there is no cure for acquired immunodeficiency syndrome (AIDS), medications have been highly effective in fighting HIV and its complications. Drug treatments help reduce the HIV virus in your body, keep your immune system as healthy as possible and decrease the complications you may develop.

Some of the drugs approved by the FDA for treating HIV and AIDS are listed below.

Nucleoside Reverse Transcriptase Inhibitors (NRTI)

These drugs interrupt the virus from duplicating, which may slow the spread of HIV in the body. They include:

  • Abacavir (Ziagen, ABC)
  • Didanosine (Videx, dideoxyinosine, ddI)
  • Emtricitabine (Emtriva, FTC)
  • Lamivudine (Epivir, 3TC)
  • Stavudine (Zerit, d4T)
  • Tenofovir (Viread, TDF)
  • Zalcitabine (Hivid, ddC)
  • Zidovudine (Retrovir, ZDV or AZT)

Combinations of NRTIs make it possible to take lower doses and maintain effectivenss. These drugs include Combivir (Zidovudine and Lamivudine), Trizivir (Zidovudine, Lamivudine and Abacavir), Epzicom (Abacavir and Lamivudine) and Truvada (Tenofovir and Lamivudine). We expect more combination drugs to be available in the future.

Side Effects of NRTIs

Side effects from taking NRTIs vary, depending on the individual. We recommend that you consult with your doctor regarding any side effects you experience. Common side effects include:

  • Abacavir (Ziagen, ABC) — Side effects may include fever, rash, fatigue, vomiting, diarrhea, abdominal pain, malaise or fatigue, loss of appetite and respiratory symptoms.
  • Dideoxyinosine (Videx, ddI) — Side effects may include nausea, vomiting and bloating. More serious side effects include pancreatitis and peripheral neuropathy. Peripheral neuropathy is a common neurological disorder resulting from damage to the peripheral nerves. Symptoms of peripheral neuropathy include a sharp, burning pain sensation in the hands or legs.
  • Lamivudine (Epivir, 3TC) — Side effects may include cough, diarrhea, dizziness, headache, loss of appetite, mild stomach cramps or pain and trouble sleeping. More serious side effects include burning, tingling, or pain in the hands, arms, feet, or legs; chills; ear, nose, or throat problems; fever; muscle aches; nausea; pale skin; severe stomach pain; skin rash; unusual tiredness or weakness; vomiting; and yellow eyes or skin.
  • Stavudine (Zerit, d4T) — Side effects may include peripheral neuropathy. Symptoms of peripheral neuropathy include a sharp, burning pain sensation in the hands or legs. In rare cases, Stavudine also may cause pancreatitis.
  • Tenofovir (Viread, TDF) — Side effects may include weakness and lack of energy, headache, diarrhea, nausea, vomiting and intestinal gas. More serious side effects include liver or kidney failure and pancreas disease.
  • Zalcitabine (Hivid, ddC) — Side effects may include oral ulcers and peripheral neuropathy. Symptoms of peripheral neuropathy include a sharp, burning pain sensation in the hands or legs.
  • Zidovudine (Retrovir, ZDV or AZT) — Side effects may include diarrhea, nausea, vomiting, headache, insomnia, weakness and fatigue, bone marrow suppression, anemia and neutropenia. Neutropenia refers to an abnormally low number of neutrophils in the blood. Neutrophils, a type of white blood cell, help fight bacterial infections. Neutropenia isn't a disease but a sign of an underlying problem. In mild cases, it may cause no symptoms. Severe neutropenia increases the risk of infection of the lungs, kidneys, blood and skin.

Protease Inhibitors (PI)

These FDA-approved drugs interrupt virus replication at a later step in the virus life cycle. Protease inhibitors include:

  • Amprenavir (Agenerase, APV)
  • Atazanavir (Reyataz, ATV)
  • Fosamprenavir (Lexiva, FOS)
  • Indinavir (Crixivan, IDV)
  • Lopinavir (Kaletra, LPV/r)
  • Ritonavir (Norvir, RIT)
  • Saquinavir (Fortovase, Invirase, SQV)

Side Effects of PIs

Side effects from protease inhibitors vary, depending on the individual. We recommend that you consult with your doctor to discuss any side effects you may experience. The following is a list protease inhibitors and their possible side effects:

  • Amprenavir (Agenerase, APV) — Side effects include nausea, diarrhea, vomiting, rash, numbness around the mouth and abdominal pain. About 1 percent of people have serious skin reactions, including Stevens-Johnson syndrome.
  • Atazanavir (Reyataz, ATV) — Side effects include headache, rash, stomach pain, vomiting, depression, increased cough, trouble sleeping, tiredness, back pain, joint pain, as well as numbness, tingling or burning of the hands or feet. More serious side effects include yellowing of the eyes or skin, change in heart rhythm, diabetes and high blood sugar, diarrhea, infection, nausea and blood in the urine.
  • Fosamprenavir (Lexiva, FOS) — Side effects may include rash, nausea and diarrhea.
  • Indinavir (Crixivan, IDV) — Side effects include change in sense of taste, diarrhea, nausea, vomiting, dizziness or drowsiness, general feeling of weakness, headache, stomach pain and trouble sleeping. More serious side effects include kidney stones, changes in body fat, increased bleeding in patients with hemophilia, high sugar and fat levels in the blood and onset or worsening of diabetes.
  • Lopinavir (Kaletra, LPV/r) — Side effects include abdominal pain, abnormal stools or bowl movements, diarrhea, feeling weak or tired, headache and nausea. In addition, patients taking Lopinavir should be monitored for possible liver problems. People taking the drug who have liver disease, such as hepatitis B or hepatitis C, may experience a worsening of their liver condition. A small number of patients have experienced severe liver problems.
  • Nelfinavir (Viracept, NFV) — Side effects include diarrhea, weakness, headache, nausea and abdominal pain.
  • Ritonavir (Norvir, RIT) — Ritonavir often is used in combination with other protease inhibitors (PIs), an approach called "Ritonavir boosting." Studies have shown that small amounts of Ritonavir, taken in combination with other PIs, can boost or increase the strength and effectiveness of some drugs and may overcome drug and food interactions. In some cases, Ritonavir boosting reduces the number of pills necessary or how often they're taken. The disadvantage is that Ritonavir interacts with many drugs, both prescription and over the counter. It is important that you speak with your doctor about all your medications before taking Ritonavir.

    Side effects include general weakness, burning or prickling sensation in the hands and feet, stomach pain, diarrhea, constipation, indigestion, flatulence, nausea, vomiting, loss of appetite, change in sense of taste, headache, dizziness, drowsiness, insomnia, fever, throat irritation, abnormal thinking, rash, sore throat and sweating. More serious effects include pancreas disease, changes in body fat, increased bleeding in patients with hemophilia, high sugar and fat levels in the blood and onset or worsening of diabetes.
  • Saquinavir (Fortovase, Invirase, SQV) — Side effects are related to the stomach and intestinal system, including diarrhea, nausea, stomach-intestinal pain, heartburn, rectal gas, vomiting, altered taste sensation, headache, fatigue, depression, sleep disturbance including insomnia, anxiety, sex drive disorder, muscle aches, rash, hepatitis and abnormal fat redistribution.

Other AIDS Medications

Fusion Inhibitors

Fusion inhibitors are a new class of drugs that act against HIV by preventing the virus from fusing with the inside of a cell, preventing it from replicating. The group of drugs includes Enfuvirtide, also known as Fuzeon or T-20.

Highly Active Antiretroviral Therapy (HAART)

In 1996, highly active antiretroviral therapy (HAART) was introduced for people with HIV and AIDS. HAART — often referred to as the anti-HIV "cocktail" — is a combination of three or more drugs, such as protease inhibitors and other anti-retroviral medications. The treatment is highly effective in slowing the rate at which the HIV virus replicates itself, which may slow the spread of HIV in the body. The goal of HAART is to reduce the amount of virus in your body, or the viral load, to a level that can no longer be detected with blood tests.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) block the infection of new cells by HIV. These drugs may be prescribed in combination with other anti-retroviral drugs. NNRTs include:

  • Delvaridine (Rescriptor, DLV)
  • Efravirenz (Sustiva, EFV)
  • Nevirapine (Viramune, NVP)

Reviewed by health care specialists at UCSF Medical Center.