“Antiretroviral therapy” refers to any HIV treatment that uses a combination of two or more drugs. A healthcare professional may prescribe at least three medications to increase the likelihood of success.
For people with HIV, antiretroviral therapy, sometimes called ART, is an important part of treating the infection, supporting health, and maintaining or improving the quality of life.
These drugs keep the amount of virus in the blood at low or undetectable levels. If the virus is undetectable, it cannot infect others.
You can learn more about the types of antiretroviral drugs, their effects and benefits below. We also connect with a few organizations that can help an individual connect with an appropriate healthcare professional.
What is antiretroviral therapy?
In 1996, specialists introduced antiretroviral therapy in response to low success rates among people taking only one HIV drug at a time.
The use of antiretroviral treatment with three drugs marked a turning point at which a diagnosis with very poor prospects became a manageable health condition.
More recently, health authorities approved two-drug therapies for HIV treatment.
Antiretroviral therapy affects the body in two ways. First, it increases the number of immune cells in the body. It also decreases the number of virus cells.
These drugs help keep a person healthy and prevent other infections. In a person taking effective antiretroviral therapy, HIV does not progress and the virus does not spread to others.
Positive effects of antiretroviral therapy
Antiretroviral drugs have these effects:
- They prevent the virus from multiplying in the blood.
- They reduce the amount of HIV in the blood.
- They increase the number of CD4 cells, which are immune cells that the virus targets.
- They prevent HIV from becoming AIDS or slow down this progress.
- They prevent the virus from being spread to other people.
- They reduce the risk of serious complications.
- They increase survival rates.
Health professionals usually prescribe a combination of three or more antiretroviral drugs. This approach has the highest probability of reducing the amount of HIV in the body.
However, a person could discuss the benefits of taking a single pill that contains multiple medications.
Antiretroviral therapy can reduce viral load to the point where it is undetectable. This means that HIV cannot be passed on to another person under any circumstances. The abbreviation for this is “undetectable = not transferable” or “U = U”.
When should I start antiretroviral treatment?
The Centers for Disease Control and Prevention (CDC) recommends that antiretroviral therapy be started as soon as possible after an HIV diagnosis.
It is important to start treatment as soon as possible, even if several years have passed since the diagnosis and the person is still healthy. Without treatment, HIV can damage the immune system and develop into AIDS.
If a person with HIV uses antiretroviral therapy as directed, it can help them live a full, healthy life.
People find support and guidance on how to start treatment from the American Academy of HIV Medicine. It also has a feature that allows people in the United States to find care providers with various specialties in their region.
An individual can also use this directory to find Ryan White HIV/AIDS program medical providers in the US. These are healthcare professionals who provide antiretroviral therapy, patient education, and mental health support.
For more information and resources about HIV and AIDS, visit our dedicated hub.
Antiretroviral drugs and therapies
There are seven classes of HIV drugs. This includes:
- Non-nucleoside reverse transcriptase inhibitors (nNRTIs)
- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Post-attachment inhibitors
- Protease inhibitors (PIs)
- CCR5 antagonists
Integrase strand transfer inhibitors (INSTI
Initial treatment regimens usually include two NRTIs and a third active antiretroviral drug that may fall into the INSTI, NNRTI, or PI class. They may sometimes contain a booster, which may be cobicistat (Tybost) or ritonavir (Norvir).
The initial antiretroviral regimen for adults and adolescents with HIV is usually one of the following:
- Bictegravir/tenofovir alafenamide/emtricitabine (Biktarvy)
- dolutegravir (Tivicay) plus tenofovir/emtricitabine (Truvada)
- dolutegravir plus emtrictabine or lamivudine. plus tenofovir alafenamide or tenofirdisoproxil fumarate
While the combinations above are typical, a doctor’s prescription depends on several factors, such as whether the person is pregnant.
Once the doctor has found a successful combination of drugs, the person’s viral load can become undetectable within 6 months. Antiretroviral therapy is not a cure for HIV, as the virus itself remains in certain body tissues in undetectable amounts.
For antiretroviral therapy to work, a person must take it exactly as prescribed, without missing doses. This prevents HIV from reproducing in the blood.
When discussing the best treatment approach, a person should inform the doctor of anything that could make it difficult to take the medication, such as a busy lifestyle or lack of health insurance. The doctor can help you solve these problems.
When recommending an antiretroviral treatment plan, healthcare professionals consider the following:
- Other health conditions
- possible side effects
- possible interactions between HIV drugs and other drugs
- the costs of HIV.
- the feasibility of consistent treatment in accordance with guidelines
Learn more about the types of HIV antiretroviral drugs.
In the past, HIV drugs caused many more side effects than they do today. And although current options may cause side effects for some people, the benefits generally far outweigh the risks.
Most side effects only last a few days or weeks. This includes:
- sleep disorders
However, some HIV medications can cause side effects that are not visible for months or years. One example is high cholesterol, a risk factor for heart disease.
People who have other health conditions or are taking other medications may be at increased risk of side effects.
And it’s important to note that HIV drugs can interact with a long list of other medications, including:
- inhaled asthma medicines, medicines for
- Erectile Dysfunction Medication
- , herbal and alternative treatments such as
To prevent harmful interactions and ensure that medications are effective, it is important that people tell their doctor about any other treatments or supplements they are taking.
Antiretroviral therapy is HIV treatment that involves two or more drugs. Although it doesn’t cure the condition, it can reduce the amount of virus in the body to undetectable levels. At this point, the virus cannot be transmitted to other people.
This treatment also boosts the immune system and reduces the risk of HIV progressing.
If a person performs treatment exactly as prescribed, their viral load may be undetectable within 6 months.