Antiretroviral Treatments for HIV Infection

Approved Antiretroviral Drug Classes

The main classes of antiretroviral treatments for HIV infection are reverse transcriptase inhibitors, protease inhibitors, and integrase inhibitors, which target different stages of the HIV life cycle and are used in combination to effectively suppress viral replication 1, 2, 3
Protease inhibitors target the viral protease enzyme that is essential for viral maturation, and examples include darunavir (boosted with ritonavir or cobicistat), which is recommended as part of combination therapy 1, 3

Integrase inhibitor-based regimens are generally recommended as first-line therapy due to their high efficacy and favorable side effect profile, according to the American Medical Association 3, 4, 5
Recommended initial regimens typically include bictegravir/tenofovir alafenamide/emtricitabine, dolutegravir/abacavir/lamivudine, and dolutegravir plus tenofovir alafenamide/emtricitabine 1
Alternative regimens may include protease inhibitor-based or NNRTI-based combinations, as suggested by the American Medical Association 3, 6

Antiretroviral therapy should be initiated as soon as possible after diagnosis to reduce morbidity and mortality, as recommended by the American Medical Association 7, 8
Drug resistance testing should be performed before starting therapy to guide regimen selection, according to the American Medical Association 2, 3
Treatment selection should consider patient-specific factors such as comorbidities, potential drug interactions, and pregnancy status, as suggested by the American Medical Association 4, 9