NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

NRTIs bind to and block reverse transcriptase (an HIV enzyme). HIV uses reverse transcriptase to convert its RNA into DNA (reverse transcription). Blocking reverse transcriptase and reverse transcription prevents HIV from replicating.

YEAR APPROVED BRAND NAME GENERIC NAME ALSO KNOWN AS MANUFACTURER
1995 Epivir* lamivudine 3TC ViiV Healthcare
1998 Ziagen* abacavir abacavir sulfate, ABC ViiV Healthcare
2001 Viread* tenofovir disoproxil fumarate tenofovir DF, TDF Gilead Sciences
2003 Emtriva* emtricitabine FTC Gilead Sciences
2015 Vemlidy** tenofovir alafenamide fumarate tenofovir AF, TAF Gilead Sciences

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

NNRTIs bind to and block HIV reverse transcriptase (an HIV enzyme). HIV uses reverse transcriptase to convert its RNA into DNA (reverse transcription). Blocking reverse transcriptase and reverse transcription prevents HIV from replicating.

YEAR APPROVED BRAND NAME GENERIC NAME ALSO KNOWN AS MANUFACTURER
1998 Sustiva* efavirenz EFV Bristol-Myers Squibb
2008 Intelence etravirine ETR Janssen Therapeutics
2011 Edurant rilpivirine rilpivirine hcl, RPV Janssen Therapeutics
2018 Pifeltro doravirine DOR Merck & Co., Inc.

PROTEASE INHIBITORS (PIs)

PIs block protease (an HIV enzyme). By blocking protease, PIs prevent new (immature) HIV from becoming a mature virus that can infect other CD4+ cells.

YEAR APPROVED BRAND NAME GENERIC NAME ALSO KNOWN AS MANUFACTURER
2003 Reyataz* atazanavir atazanavir sulfate, ATV Bristol-Myers Squibb
2006 Prezista* darunavir darunavir ethanolate, DRV Janssen Therapeutics

 ENTRY INHIBITORS

Entry inhibitors work by attaching themselves to proteins on the surface of CD4 cells or proteins on the surface of HIV. In order for HIV to bind to CD4 cells, the proteins on HIV’s outer coat must bind to the proteins on the surface of CD4 cells. Entry inhibitors prevent this from happening.

YEAR APPROVED BRAND NAME GENERIC NAME ALSO KNOWN AS MANUFACTURER
2007 Selzentry maraviroc MVC ViiV Healthcare
2018 Trogarzo ibalizumab-uiyk ibalizumab, IBA Thera Technologies
2020 Rukobia fostemsavir fostemsavir tromethamine, FTR ViiV Healthcare

 INTEGRASE INHIBITORS

Integrase inhibitors block integrase (an HIV enzyme). HIV uses integrase to insert (integrate) its viral DNA into the DNA of the host CD4 cells. Blocking integrase prevents HIV from replicating.

YEAR APPROVED BRAND NAME GENERIC NAME ALSO KNOWN AS MANUFACTURER
2007 Isentress, Isentress HD raltegravir raltegravir potassium, RAL Merck & Co., Inc.
2013 Tivicay, Tivicay PD dolutegravir dolutegravir sodium, DTG ViiV Healthcare
2014 Vitekta** elvitegravir Gilead Sciences
2021 Vocabria cabotegravir cabotegravir sodium, CAB ViiV Healthcare

 PHARMACOKINETIC ENHANCERS (PK ENHANCERS)

PK enhancers are used to boost the effectiveness of another drug. When the two drugs are given together, the PK enhancer interferes with the breakdown of the other drug, which allows the drug to remain in the body longer at a higher concentration. PK enhancers are included in some HIV treatment regimens.

YEAR APPROVED BRAND NAME GENERIC NAME ALSO KNOWN AS MANUFACTURER
1996 Norvir* ritonavir RTV AbbVie Inc.
2014 Tybost cobicistat COBI Gilead Sciences

COMBINATION HIV MEDICATIONS

Combination HIV medications contain 2 or more HIV medicines from 1 or more drug classes.

YEAR APPROVED BRAND NAME INDIVIDUAL COMPONENTS ALSO KNOWN AS MANUFACTURER
2000 Kaletra* lopinavir – PI

ritonavir – PI

LPV / RTV AbbVie Inc.
2004 Epzicom* abacavir sulfate – NRTI

lamivudine – NRTI

ABC / 3TC ViiV Healthcare
2004 Truvada* emtricitabine – NRTI

tenofovir DF – NRTI

FTC / TDF Gilead Sciences
2006 Atripla* efavirenz – NNRTI

emtricitabine – NRTI

tenofovir DF – NRTI

EFV / FTC / TDF Gilead Sciences
2011 Complera emtricitabine – NRTI

rilpivirine — NNRTI

tenofovir DF – NRTI

FTC / RPV / TDF Gilead Sciences
2012 Stribild elvitegravir – Integrase Inhibitor

cobicistat – PK Enhancer

emtricitabine — NRTI

tenofovir DF – NRTI

QUAD

EVG / COBI / FTC / TDF

Gilead Sciences
2014 Triumeq abacavir sulfate – NRTI

dolutegravir – Integrase Inhibitor

lamivudine – NRTI

ABC / DTG / 3TC ViiV Healthcare
2015 Prezcobix darunavir – PI

cobicistat – PK Enhancer

DRV / COBI Janssen Therapeutics
2015 Evotaz atazanavir – PI

cobicistat – PK Enhancer

ATV / COBI
2015 Genvoya elvitegravir – Integrase Inhibitor

cobicistat – PK Enhancer

emtricitabine – NRTI

tenofovir AF – NRTI

EVG / COBI / FTC / TAF Gilead Sciences
2016 Odefsey emtricitabine – NRTI

rilpivirine – NNRTI

tenofovir AF – NRTI

FTC / RPV / TAF Gilead Sciences
2016 Descovy emtricitabine — NRTI

tenofovir AF – NRTI

FTC/TAF Gilead Sciences
2017 Juluca dolutegravir – Integrase Inhibitor

rilpivirine – NNRTI

DTG / RPV ViiV Healthcare
2018 Biktarvy bictegravir – Integrase Inhibitor

emtricitabine – NRTI

tenofovir AF – NRTI

BIC / FTC / TAF Gilead Sciences
2018 Symfi*

Symfi Lo*

efavirenz – NNRTI

lamivudine – NRTI

tenofovir DF – NRTI

EFV / 3TC / TDF Viatris
2018 Cimduo lamivudine – NRTI

tenofovir DF – NRTI

Temixys

3TC / TDF

Viatris
2018 Delstrigo doravirine – NNRTI

lamivudine – NRTI

tenofovir DF – NRTI

DOR / 3TC / TDF Merck & Co., Inc.
2018 Symtuza darunavir – PI

cobicistat – PK Enhancer

emtricitabine – NRTI

tenofovir AF – NRTI

DRV / COBI / FTC / TAF Janssen Therapeutics
2019 Dovato dolutegravir – Integrase Inhibitor

lamivudine – NRTI

DTG / 3TC ViiV Healthcare
2021 Cabenuva cabotegravir – Integrase Inhibitor

rilpivirine – NNRTI

CAB / RPV ViiV Healthcare

*Generic versions have been approved under the President’s Emergency Plan for AIDS Relief (PEPFAR).

**Not available or not used as an individual ARV. Only available or used as a component of combination medications.

SIDE EFFECTS

ARVs can have adverse effects. Most are manageable, but some can be serious. Newer drugs tend to cause fewer and less severe side effects. The benefits of taking HIV medications typically outweigh the side effects. These treatments can help people live long, healthy lives with reduced risks of HIV-related complications and transmission. The potential side effects vary depending on the types of medication a person uses. Also, the same medication can have different side effects in different people. Read more about side effects of ARVs.

INTERACTIONS WITH OTHER SUBSTANCES

ARVs can interact with other substances, including other medications, supplements, and herbal products.

To avoid interactions, discuss all your current medications and supplements with your healthcare provider, as these can influence how HIV medications work. Read more about drug interactions of ARVs.

THE BOTTOM LINE

Antiretroviral medications (ARVs) are effective treatments for HIV. Organizations around the world recommend that all people with HIV begin antiretroviral therapy (ART) as soon as possible after receiving their diagnosis. ARVs can reduce the risk of HIV-related complications, stop the virus from progressing, and prevent transmission to others. In addition, ARVs increase a person’s quality of life and life expectancy.

Some people may experience side effects. However, these may go away after a few weeks of treatment. There are several classes of ARVs, and if one causes side effects another may not.

Your healthcare provider can offer information and guidance about treatment options for HIV.

MORE INFORMATION

HIVInfo.NIH.gov: FDA-Approved HIV Medicines

U.S. Food & Drug Administration (FDA): HIV and AIDS: Medicines to Help You

Reviewed March 2021

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