Treatment of HIV infection underwent significant changes following the approval of zidovudine or azidothymidine (AZT) in 1987. Currently, we have a total of seven classes of antiretrovirals (ARVs) available. These include nucleoside/nucleotide reverse transcriptase inhibitors or NRTIs, non-nucleoside reverse transcriptase inhibitors or NNRTIs, protease inhibitors or PIs, integrase strand transfer inhibitors or INSTIs, CCR5 antagonists, post-attachment inhibitors, and fusion inhibitors. The antiretrovirals have evolved over four decades into potent and better-tolerated drugs, with simplified dosages. This evolution has facilitated adherence and contributed to decreased morbidity and mortality for persons with HIV. However, antiretrovirals are still not innocuous and present many challenges to the clinician. Many antiretrovirals have significant side effects and drug-drug interactions. These are particularly important when we consider that HIV infection is a chronic illness that requires lifetime use of ARVs. In this chapter, we review the HIV life cycle, the most commonly used ARVs within each class, as well as current guidelines for the treatment of HIV infection.
Principles of HIV treatment (pp. 391-413)
In Bourgeois JA, Cohen MAA, Makurumidze G (Eds.)
HIV psychiatry: A practical guide for clinicians.
Cham: Springer. doi: 10.1007/978-3-030-80665-1_16.