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In order for HIV treatment to be effective for a long time,
it has been found that you need to take more than one medicines
at a time. This is what is known as combination therapy or
Highly Active Antiretroviral Therapy (HAART). The general
recommendation is to use a minimum of 3 different drugs/medicines.
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| If one drug/medicine is taken on its own,
after a period of time, the medicine will stop working. After
a period of time, HIV will no longer be affected by this one
drug/medicine. Hence, the virus will start replicating again
as before. This condition is known as the virus becoming resistant
to the drugs/medicine. If 2 or more medicine are taken together
slows down the production of HIV at all stages and vastly reduces
the rate at which resistance develops. |
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| There are 3 main groups of drugs; each
of these groups attacks HIV in a different way: |
- Nucleoside Reverse Transcriptase
Inhibitors (NRTI)
The first group of ARV is the Nucleoside Reverse Transcriptase
Inhibitors (NRTI). HIV needs an enzyme called reverse transcriptase
in order to be able to infect healthy T-cells and reproduce
itself. As the name conveys, NRTI inhibits reverse transcriptase
that slows down the production of the reverse transcriptase
enzyme and disable HIV infection and replication.
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)
The second group of ARV is the non-nucleoside reverse transcriptase
inhibitors (NNRTI). This group of drugs also stops HIV from
infecting T-cells by intervening with the transcriptase
of the virus. The NNRTI binds to the T-cell's reverse transcriptase,
hence confusing the HIV virus. NNRTI drugs blocks the duplication
and the spread of HIV.
- Protease Inhibitors
The third type of ARV is the Protease Inhibitors (PI)
group. As the name says, PI inhibits protease. Almost all
living cells contain protease. Protease is a digestive enzyme
that breaks down protein and is one of the many enzyme that
HIV uses to reproduce itself. HIV attacks the long and healthy
chains of enzyme & proteins in the cells and cuts them into
smaller pieces.
PI takes effect before HIV has a chance to attack the healthy
enzyme and proteins. The NRTI and NNRTI only have effect
on newly infected cells. PI can slow the process of immature
HIV preventing HIV to mature, thus making them infectious.
PI also work in cells that have been infected for a long
time, by slowing down the reproduction of the virus.
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NRTI* acts like a broken building
blocks so that the HIV virus that multiplies in your
T-cells is built on broken blocks - it makes it weaker
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NNRTI* gives wrong instructions
to HIV and confuses the building process, so their building
is weak and easily collapsed
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PI* are like workers putting defective
parts in each new virus being built, again making the
HIV weak
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| ARV is sometimes referred by their chemical
name, for example AZT. The second name for the drug is the common
name for all drug with the same chemical structure, AZT is also
known as zidovudine. The third name is the brand name given
by the pharmaceutical company. One of the brand names for zidovudine
is Retrovir. |
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Chemical name
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Brand name
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| NRTI |
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zidovudine
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Retrovir/AZT
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lamivudine
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3TC
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zivovudine + lamivudine
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Combivir/Duovir
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D4T
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Zerit/Stavudine
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DDL
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Videx/Videx EC
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| NNRTI |
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nevirapine
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Viramune/Nevimune
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efavirenz
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Stocrin
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| PI |
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indinavir
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Crixivan
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nelfinavir
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Viracept
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ritonavir
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Norvir
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lopinavir+ ritonavir
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Kaletra
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saquinavir
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Fortovase, Invirase
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