Although there is no permanent treatment for HIV, there are ways to treat and manage the condition to improve longevity and quality of life. One of the ways doctors treat HIV is through the use of drugs called nucleoside / nucleotide reverse transcriptase inhibitors (NRTIs).
HIV is a virus that attacks the human immune system and kills specific white blood cells that fight infections. These cell types are known as CD4 cells.
HIV kills these CD4 cells so that they are unable to fight common infections in the body. As HIV progresses, the reduction in CD4 cells can lead to what doctors call opportunistic infections. However, early treatment can help prevent this result.
Physicians can use NRTIs as part of a plan to treat people with HIV. NRTIs stop HIV from replicating and killing CD4 cells.
This article provides an overview of the treatment of HIV using NRTIs. He explains how they work and lists the approved medicines currently available as treatment options.
NRTIs are one of the types of antiretroviral drugs that treat HIV. They work by preventing the virus from multiplying in the body. Especially for HIV, NRTIs act by blocking reverse transcriptase, the enzyme that HIV needs to replicate.
HIV cannot reproduce on its own, which means that it needs a cell to reproduce. The cells that HIV enters are CD4 cells, which are white blood cells that fight infections.
Once HIV enters CD4 cells, it converts its RNA into DNA using the enzyme reverse transcriptase. When someone with HIV is taking NRTI drugs, the enzyme cannot properly transform RNA into DNA, which slows the progression of HIV.
The Food and Drug Administration (FDA) has approved the following NRTIs:
- abacavir (Ziagen)
- emtricitabine (Emtriva)
- lamivudine (epivir)
- tenofovir alafenamide (Vemlidy)
- tenofovir disoproxil fumarate (Viread)
- zidovudine (retrovir)
In most cases, HIV treatment combines two or more NRTIs. The Ministry of Health and Human Services notes that some common combinations include:
- abacavir plus lamivudine (Epzicom)
- abacavir plus lamivudine plus zidovudine (Trizivir)
- lamivudine plus zidovudine (Combivir)
- tenofovir alafenamide plus emtricitabine (Descovy)
- tenofovir disoproxil fumarate plus emtricitabine or lamivudine (Truvada or Cimduo)
Usually, your doctor will do a drug resistance test to determine if NRTIs are likely to work. They may also consider prescribing other medicines if a person is pregnant or has other health conditions besides HIV.
Most NRTIs are available in pill form. However, young children who cannot swallow may take liquid forms of the medication instead.
Healthcare professionals are more likely to start a person with HIV with a treatment plan for one or two NRTIs in addition to another antiretroviral drug.
Although it is safe to take NRTIs with or without food, it is always important to take them as prescribed. One should avoid skipping any doses, as HIV can spread and build resistance to NRTIs.
Most medications, including NRTIs, can have side effects. Although these side effects are often mild, they can be permanent.
One should consult a doctor if there are any concerns about the side effects he is experiencing. Your doctor may discuss with them how to manage the side effects or transfer their prescription to another NRTI.
Some common side effects of multiple NRTIs include:
Although uncommon, NRTIs can also cause:
- accumulation of lactic acid in the blood
- liver problems
- Pancreatitis
- skin changes, such as discoloration
Allergic reactions
Some people may experience severe allergic reactions to abacavir. This response is common among people who have a genetic variant called HLA-B * 5701 that doctors can detect by a blood test.
One should talk to a healthcare professional if they experience the following symptoms while using abacavir:
- fever
- skin irritation or rash
- nausea, vomiting or diarrhea
- Lack of air
A 2018 article states that abacavir reactions are severe and can be fatal. Therefore, your doctor may consider other options.
Some studies show that abacavir may increase the chances of heart disease, such as heart attacks, especially among those with cardiovascular risk factors. Although more research is needed to confirm this, people with known risk factors for heart disease should discuss this with their doctor before taking abacavir.
Other side effects
Tenofovir disoproxil fumarate may cause renal impairment and loss of bone density.
Tenofovir alafenamide is a standard substitute for NRTI for people who have experienced the above side effects with tenofovir disoproxil fumarate. Although it is safer for bones and kidneys than tenofovir disoproxil fumarate, it can increase body weight.
Zidovudine may cause anemia and lipodystrophy. It can also reduce the number of white blood cells, increase lipid levels or cause muscle weakness, in rare cases.
One should seek immediate medical attention if any of the following symptoms occur when taking NRTIs:
- each rash
- rapid breathing
- jaundice
- stomach pain
- vomiting
- bloated belly
- feeling of needles in the legs or arms
HIV is a viral infection that a person can treat and manage well if diagnosed at an early stage. Doctors use antiretroviral drugs to control HIV.
NRTIs are a class of drugs that prevent the virus from copying and invading the bloodstream. Taking prescription drugs will help control the condition and reduce the risk of developing AIDS.
People should seek medical attention immediately if they notice any side effects while taking HIV medication.
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