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Antiretrovirals

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Anti-HIV drug classes

  • Nucleoside reverse transcriptase inhibitors (NRTIs or ’nukes’).
  • Nucleotide reverse transcriptase inhibitors (NtRTIs).
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs or ‘non-nukes’).
  • Protease inhibitors (PIs).
  • Fusion and entry inhibitors.
  • Integrase inhibitors.

Treatment guidelines [PDF] have been developed by the British HIV Association (BHIVA), the organisation for specialist HIV doctors in the UK. They set out the medical treatment people living with HIV in the UK should receive.

These guidelines recommend that everyone with HIV, regardless of their CD4 count, should start treatment immediately, usually with three anti-HIV drugs.

For people who have not been on HIV treatment, it’s recommended to start on a combination containing two NRTIs and either a ritonavir-boosted protease inhibitor, an NNRTI, or an integrase inhibitor.

The preferred NRTIs for starting HIV treatment are emtricitabine (brand name Emtriva) and tenofovir disproxil (Viread), also available combined in a pill called Truvada. These drugs are available combined with efavirenz in a pill called Atripla; combined with rilpivirine in a pill called Eviplera; or combined with elvitegravir and cobicistat in a pill called Stribild. Two other NRTIs, lamivudine and abacavir (combined in a pill called Kivexa), are an alternative for some people.

The guidelines recommend taking a third, additional drug, which is usually one of the following: atazanavir (Reyataz), darunavir (Prezista), raltegravir (Isentress), dolutegravir (Tivicay), rilpivirine (Edurant) or elvitegravir (Vitekta). Atazanavir and darunavir are boosted with another protease inhibitor, ritonavir (Norvir) to increase their levels in the body. Elvitegravir is boosted by a drug called cobicistat (Tybost) and is usually prescribed in the combination pill called Stribild. An alternative third drug to the preferred options is efavirenz (Sustiva).

Interactions 

I find the best sites for checking interactions in HIV medications are these

http://arv.ucsf.edu/InSite?page=ar-00-02

https://www.hiv-druginteractions.org/checker

https://www.hiv.uw.edu/pdf/antiretroviral-therapy/drug-drug-interactions/core-concept/all

 Simvastatin 

Omeprazole

Flutcasone 

Budesonide 

(Becloomethasone safe)

Simvastatin Omeprazole Flutcasone Budesonide

 

Tenofovir Lamivudine Emtricitabine Efavirenz

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