HIV/AIDS Living With Aids In America

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COCKTAIL DRUGS: While most researchers believe that antiviral therapy will not kill off all HIV in the body, many do believe that it can lower the amount of the virus and repair the immune system to the extent that patients can discontinue taking the drugs.

The drugs, sometimes called antiretroviral drugs because AIDS is a retrovirus, are frequently referred to as "cocktail" drugs because of their prescribed combination. HIV frequently creates mutations that are different from its original virus and can therefore resist a single drug.

A mutant can often "get around" even two drugs, but it is much more difficult for a mutation to simultaneously resist three drugs. The drug triplet lowers some people's viral loads - the amount of HIV virus in the bloodstream - to the undetectable level.

Each antiviral drug has side effects and doctors consider three things when prescribing them: 1) your viral load 2) your T-cell count - white blood cells that lead the attack against infection - and 3) any symptoms you have had.

Click the numbers for details on where certain drug cocktails operate.

Sources: CDC; National Institute of Allergy and Infectious Diseases; NIH; AIDS.ORG Inc.

1

REVERSE TRANSCRIPTASE INHIBITORS (NRTI): Also called "nukes," this first effective class of drugs works at the stage where HIV genetic material is converted from RNA into DNA. The drug acts by incorporating itself into the DNA of the virus, thereby stopping the building process. The DNA is therefore incomplete and cannot produce a new virus. Seven drugs have been approved in this class. They are: AZT, ddC, d4T, ddl, 3TC, abacavir and a combination of AZT and 3TC called Combivir (TM).

2

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTI): The newest class of antiretrovirals, these drugs act at the same stage as reverse transcriptase inhibitors. But instead of incorporating into the DNA, it binds directly onto the reverse transcriptase - the enzyme HIV uses to convert RNA into DNA. In this manner the drug prevents the conversion of RNA into DNA. The three NNRTI's that have been approved are nevirapine, delavirdine and efavirenz.

3

PROTEASE INHIBITORS: These drugs work at the last stage of the virus' cycle. They prevent HIV fully assembling and leaving the infected CD4+ cell. Five protease inhibitors have been approved. They are: saquinavir, indinavir, ritonavir, nelfinavir and amprenavir.

4

BEING RESEARCHED: Researchers are in the process of trying to develop drugs to prevent the first stage in the HIV production cycle, where the HIV attaches itself to the cell.

So far, the two most common "drug cocktail" approaches used are combining two NRTIs, such as AZT and 3TC, with a protease inhibitor, like nelfinavir or indinavir, or with an NNRTI, like efavirenz.