Treatments for HIV Infection

In 1981, when AIDS was first seen in the U.S., there were no medicines to fight HIV and few treatments for the opportunistic infections (OIs) and cancers that happen when a person has AIDS. But over the past 20 years, researchers have developed drugs to fight both HIV infection and AIDS OIs and cancers. There is no cure for AIDS and when a person becomes infected with HIV, they will need life long treatment.

The Food and Drug Administration has approved several types of drugs for treating HIV infection. A main goal of treatment is to stop the virus from replicating, or making copies of itself. When the virus is allowed to copy itself, it increases its numbers in a person's body, weakening the immune system. Over time, a person is no longer able to fight off infection and becomes sick.

One group of drugs stops the virus from replicating at an early stage in its life cycle. These drugs are called nucleoside reverse transcriptase, or RT inhibitors. RT inhibitors include zidovudine (AZT), zalcitabine (ddC), dideoxyinosine (ddI), stavudine (d4T) and lamivudine (3TC). These drugs may slow the spread of HIV in the body and delay the onset of OIs.

A second, and more recent, group of drugs are called protease inhibitors. They stop the virus from making copies of itself at a later stage in its life cycle. These drugs include ritonavir (Norvir), saquinivir (Invirase), indinavir (Crixivan), amprevnivir (Agenerase), nelfinavir (Viracept), and Iopinavir (Kaletra).

One challenge to treating HIV infection is persons with HIV can build resistance to these drugs. (Resistance means that the drugs stop working.) Health care providers must use several of these drugs at the same time, called a combination treatment, to stop the virus from replicating. Another challenge is the side effects caused by drug treatment. Side effects can vary widely from person to person. Some people can have severe side effects, including death, and may have to stop or change treatments.

One type of treatment, called highly active antiretroviral therapy, or HAART, has greatly improved the health of many people with AIDS. It can lower the amount of virus in a person's blood to levels so low that it is hard to detect with a blood test. This can mean relief from symptoms and OIs, increasing the quality of life for a person living with AIDS. There are also treatments for OIs and cancers.