Antiretrovial Therapy

Antiretrovial Therapy ●​ Combined tx, managing infection on HIV ●​ Multiple antiretroviral drugs ○​ Attacks on multiple stage of HIV life cycle ●​ Suppress viral replication ○​ Improvement of immune function ○​ Prevention on progression of AIDS ●​ Suppression of HIV viral load ○​ Under detectable levels ●​ Restoration and preservation of immune function ○​ Increase in CD4+T cell count ●​ Reduce HIV related morbidity + mortality ●​ HIV transmission prevention ●​ Life expectancy improvement Mechanism ●​ ART on blocking different stage of HIV life cycle ○​ Viral entry on host cell ○​ Reverse transcription of viral RNA ⇒ DNA ○​ Integration of viral DNA ⇒ Host gene ○​ Maturation assembly ■​ Viral particles build up ●​ Multiple drug (drug cocktail) ○​ Prevention of viral resistance ○​ Improves treatment effectiveness Major classes ●​ Nucleoside and Nucleotide Reverse Transcriptase Inhibitor ○​ Blocking reverse transcriptase enzyme ○​ Prevention of conversion of viral RNA to DNA ■​ ex) ●​ Zidovudine ●​ Lamivudine ●​ Tenofovir ●​ Abacavir ●​ Non-Nucleoside Reverse Transcriptase Inhibitors ○​ Binds directly to reverse transcriptase ○​ Inhibits its activity ■​ ex) ●​ Efavirenz ●​ Nevirapine ●​ Etravirine ●​ Protease Inhibitors ○​ Inhibition of HIV protease enzyme ○​ Prevention of maturation of viral particles ■​ ex) ●​ Lopinavir ●​ Atazanavir ●​ Darunavir ●​ Integrase Strand Transfer Inhibitors ○​ Blocking integration of viral DNA entering host genome ■​ ex) ●​ Taltegravir ●​ Dolutegravir ●​ Bictegravir ●​ Entry or Fusion Inhibitors ○​ Prevention of HIV from entering CD4 cells in first place ■​ ex) ●​ Maraviroc ○​ CCR5 antagonist ●​ Eufuvirtide ○​ Fusion inhibition