Anti-retrovirals

Anti-retrovirals

Anti-retrovirals are a class of medications used primarily to treat HIV/AIDS. These drugs work by inhibiting the replication of the HIV virus within the human body, thereby reducing the viral load and improving the immune function of the patient. Anti-retrovirals are a critical component of antiretroviral therapy (ART), which is the standard treatment for HIV infection.

Mechanism of Action

Anti-retrovirals target different stages of the HIV life cycle. The main classes of anti-retroviral drugs include:

• Nucleoside Reverse Transcriptase Inhibitors (NRTIs): These drugs mimic the natural nucleosides used by the virus to synthesize DNA, thereby terminating the DNA chain and preventing viral replication.
• Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs): These drugs bind to and inhibit the reverse transcriptase enzyme, preventing the conversion of viral RNA into DNA.
• Protease Inhibitors (PIs): These drugs inhibit the protease enzyme, which is necessary for the maturation of infectious viral particles.
• Integrase Inhibitors: These drugs block the integrase enzyme, preventing the integration of viral DNA into the host cell genome.
• Entry Inhibitors: These drugs prevent the virus from entering host cells by blocking the fusion of the viral envelope with the host cell membrane.

History

The development of anti-retrovirals began in the late 1980s with the approval of zidovudine (AZT), the first NRTI. Since then, numerous other drugs have been developed, leading to the current standard of combination therapy, which uses multiple drugs from different classes to effectively suppress the virus.

Clinical Use

Anti-retrovirals are used in combination to form highly active antiretroviral therapy (HAART). This approach reduces the risk of drug resistance and improves treatment efficacy. The goal of ART is to achieve and maintain an undetectable viral load, which significantly reduces the risk of HIV transmission and improves the quality of life for patients.

Side Effects

While anti-retrovirals are generally well-tolerated, they can cause side effects, which vary depending on the specific drug and class. Common side effects include nausea, diarrhea, and fatigue. Long-term use can lead to more serious effects such as metabolic changes and cardiovascular issues.

Resistance

HIV can develop resistance to anti-retrovirals, which is why adherence to prescribed regimens is crucial. Resistance testing is often performed to guide the selection of appropriate drug combinations.

Also see

• HIV/AIDS
• Antiretroviral therapy
• HIV prevention
• Viral load
• Drug resistance