Although there is no permanent cure for HIV, there are ways to treat and manage the disease to improve a person’s longevity and quality of life. One way doctors treat HIV is to use drugs called nucleoside / nucleotide reverse transcriptase inhibitors (NRTIs).
HIV is a virus that attacks the human immune system and kills specific white blood cells that fight infections. These types of cells are commonly known as CD4 cells.
HIV kills these CD4 cells so that they are unable to fight the body’s usual infections. As HIV progresses, the reduction in CD4 cells can lead to what doctors call opportunistic infections. However, early treatment can help prevent this outcome.
Doctors may use INTIs as part of the treatment plan for someone with HIV. INTIs prevent HIV from replicating and killing CD4 cells.
This article provides an overview of HIV treatment using INTI. It explains how they work and lists the approved medications currently available as treatment options.
INTIs are one of the types of antiretroviral drugs that treat HIV. They work by preventing the virus from multiplying in the body. Especially for HIV, INTIs work by blocking reverse transcriptase, the enzyme that HIV needs to replicate.
HIV cannot replicate on its own, which means it needs a cell to multiply. The cells that enter HIV are CD4 cells, which are white blood cells that fight infections.
After HIV enters CD4 cells, it changes its RNA into DNA using the enzyme reverse transcriptase. When someone with HIV takes NRTI drugs, the enzyme cannot properly transform RNA into DNA, which slows the progression of HIV.
The Food and Drug Administration (FDA) has approved the following NRTIs:
- abacavir (Ziagen)
- emtricitabine (Emtriva)
- lamivudine (Epivir)
- tenofovir alafenamide (Vemlidy)
- tenofovir disoproxil fumarate (Viread)
- zidovudine (Retrovir)
In most cases, HIV treatment combines two or more INTIs. The Department of Health and Human Services notes that some common combinations include:
- abacavir plus lamivudine (Epzicom)
- abacavir plus lamivudine plus zidovudine (Trizivir)
- lamivudine plus zidovudine (Combivir)
- tenofovir alafenamide plus emtricitabine (Descovy)
- tenofovir disoproxil fumarate plus emtricitabine or lamivudine (Truvada or Cimduo)
Typically, a doctor will perform a drug resistance test to determine if NRTIs are likely to work. They might also consider prescribing other medications if a person is pregnant or has other health problems along with HIV.
Most INTIs come in pill form. However, young children who cannot swallow can take liquid forms of the drugs.
Health care professionals are more likely to initiate a person with HIV into a treatment plan with one or two INTIs in addition to another antiretroviral drug.
Although it is safe to take INTI with or without meals, it is always essential to take them as prescribed by your doctor. A person should avoid skipping any dose, as HIV can spread and generate resistance to INTIs.
Most drugs, including INTIs, can have side effects. While these side effects are usually mild, they can be persistent.
A person should consult a doctor if they have any concerns about the side effects they are experiencing. Your doctor can discuss with them how to manage side effects or change your prescription to another INTI.
Some common side effects of multiple INTIs include:
Although uncommon, INTIs can also cause:
- accumulation of lactic acid in the blood
- liver problems
- pancreatitis
- skin changes, such as discoloration
Allergic reactions
Some people may experience severe allergic reactions to abacavir. This response is common among people who have a genetic variant called HLA-B * 5701, which doctors can detect by a blood test.
A person should talk to a healthcare professional if they experience the following symptoms while using abacavir:
- fever
- irritation or rash
- nausea, vomiting, or diarrhea
- shortness of breath
A 2018 article states that the reactions of abacavir are serious and could be fatal. Therefore, a doctor may consider other options.
Some research suggests that abacavir may increase the chances of suffering from heart disease, such as heart attacks, especially among those with cardiovascular risk factors. Although more research is needed to confirm this, people with known risk factors for heart conditions should discuss this with a doctor before taking abacavir.
Other side effects
Tenofovir disoproxil fumarate can cause kidney disorders and loss of bone density.
Tenofovir alafenamide is a standard NRTI replacement for people who have experienced the above side effects with tenofovir disoproxil fumarate. Although it is safer for bones and kidneys than tenofovir disoproxil fumarate, it can increase body weight.
Zidovudine can cause anemia and lipodystrophy. It can also reduce white blood cell count, increase lipid levels or cause muscle weakness, in rare cases.
A person should seek immediate medical attention if any of the following symptoms occur when taking NRTI:
- rash
- fast breathing
- jaundice
- a stomachache
- vomiting
- bloated stomach
- a sensation of needles and needles in the feet or hands
HIV is a viral infection that a person can treat and manage well if they are diagnosed at an early stage. Doctors use antiretroviral drugs to control HIV.
INTIs are a class of drugs that prevent the virus from making copies of itself and invading the blood. Taking the medication as prescribed will help control the disease and reduce the risk of a person developing AIDS.
People should seek medical attention immediately if they notice any side effects while taking HIV medications.