The aim of antiretroviral treatment is to keep the amount of HIV in the body at a low level.

T
his stops any weakening of the immune system and allows it to recover from any damage that
HIV might have caused already.

The drugs are often referred to as: antiretrovirals, ARVs, anti-HIV or anti-AIDS drugs.

Taking two or more antiretroviral drugs at a time is called combination therapy. Taking a co
mbination of three or more anti-HIV drugs is sometimes referred to as Highly Active Antiretr
oviral Therapy (HAART).

If only one drug was taken, HIV would quickly become resistant to it and the drug would sto
p working. Taking two or more antiretrovirals at the same time vastly reduces the rate at whic
h resistance would develop, making treatment more effective in the long term. Our starting,
monitoring and switching HIV treatment page has more about drug resistance.

The leading recommendations for antiretroviral treatment were published by the World Healt
h Organisation (WHO) in 2013. 1 For adults and adolescents, they recommend starting on a fi
rst line therapy of two nucleoside reverse-transcriptase inhibitors (NRTIs) plus a non-nucleos
ide reverse-transcriptase inhibitor (NNRTI). The favoured recommendation is a fixed-dose co
mbination (just one pill) of:

 TDF - Tenofovir
 3TC - Lamivudine or FTC - Emtricitabine
 EFV - Efavirenz

Speak to your health care provider about the most suitable available option for you. See our T
reatment for Children page for specific recommendations for children.

The choice of drugs to take can depend on a number of factors, including the availability and
price of drugs, the number of pills, the side effects of the drugs, the laboratory monitoring req
uirements and whether there are co-blister packs or fixed dose combinations available. Most
people living with HIV in the developing world still have very limited access to antiretroviral
treatment and often only receive treatment for the diseases that occur as a result of a weaken
ed immune system. Such treatment has only short-term benefits because it does not address th
e underlying immune deficiency itself.

At the beginning of treatment, the combination of drugs that a person is given is called first li
ne therapy. If after a while HIV becomes resistant to this combination, or if side effects are pa
rticularly bad, then a change to second line therapy is usually recommended.

Second line therapy recommendations by WHO suggest two NRTIs and a ritonavir-boosted p
rotease inhibitor (PI). 2

Our starting, monitoring and switching HIV treatment page has more information about chan
ging HIV treatment.

There are more than 20 approved antiretroviral drugs but not all are licensed or available in e
very country. See our drugs table for a comprehensive list of antiretroviral drugs approved by
the American Food and Drug Administration.
There are five groups of antiretroviral drugs. Each of these groups attacks HIV in a different
way.

First approv
Antiretroviral drug class Abbreviations ed to treat H How they attack HIV
IV
N R T I s , NRTIs interfere with the action o
Nucleoside/Nucleotide Reve nucleoside anal f an HIV protein called reverse tr
1987
rse Transcriptase Inhibitors o g u e s , anscriptase, which the virus need
nukes s to make new copies of itself.
NNRTIs,
NNRTIs also stop HIV from repl
Non-Nucleoside Reverse Tr non-nucleosides
1997 icating within cells by inhibiting
anscriptase Inhibitors ,
the reverse transcriptase protein.
non-nukes
PIs inhibit protease, which is ano
Protease Inhibitors PIs 1995 ther protein involved in the HIV r
eplication process.
Fusion or entry inhibitors prevent
Fusion or Entry Inhibitors 2003 HIV from binding to or entering
human immune cells.
Integrase inhibitors interfere with
the integrase enzyme, which HI
Integrase Inhibitors 2007
V needs to insert its genetic mate
rial into human cells.

NRTIs and NNRTIs are available in most countries. Fusion/entry inhibitors and integrase inhi
bitors are usually only available in resource-rich countries.

Protease inhibitors are generally less suitable for starting treatment in resource-limited setting
s due to the cost, number of pills which need to be taken, and the particular side effects cause
d by protease drugs.