Antiretroviral therapy

Also called ART

Key points about antiretroviral therapy

Antiretroviral therapy, or ART, refers to a combination of antiviral medicines used to treat HIV (human immunodeficiency virus).
These work by stopping the virus replicating in your body, allowing your immune system to repair itself and preventing further damage.
Find out about antiretroviral therapy and possible side effects.

There are currently several classes of antiretrovirals that work in different ways against HIV.

Antiretroviral drug class	Examples
Nucleoside reverse transcriptase inhibitors	Abacvir (Ziagen®), emtricitabine (Emtriva®), lamivudine (Zetlam®, 3TC®, Zeffix®), tenofovir disoproxil, zidovudine (Retrovir®)
Protease inhibitors	Atazanavir, darunavir (Prezista®), lopinavir (Aluvia®), ritonavir (Norvir®)
Non-nucleoside reverse transcriptase inhibitors	Efavirenz (Stocrin®), etravirine (Intelence®), nevirapine (Viramune®)
Integrase strand transfer inhibitors	Dolutegravir (Tivicay®), raltegravir (Isentress®)

Fixed-dose combinations

Some antiretroviral medicines have been combined into 1 pill, known as a "fixed-dose combination". This means that the most common treatments for people just diagnosed with HIV involve taking just 1 or 2 pills a day.

Examples are:

Tenofovir disoproxil/emtricitabine
Abacavir/lamivudine (Kivexa ®)
Efavirenz/emtricitabine/tenofovir
Dolutegravir/lamivudine (Dovato ®)
Lamivudine/Zidovudine

Read a complete list of antiretroviral medicines currently available in Aotearoa New Zealand(external link).

There's no set rule on when to start HIV treatments, however, evidence shows that there are health benefits to starting as early after your diagnosis as possible.

Your healthcare provider or HIV specialist will be aware of current guidelines on treatment and what medicines are funded in Aotearoa New Zealand.

Starting treatment for HIV is a long-term commitment. It‘s important to keep taking your antiviral medicine because if you stop taking it, or don’t take it regularly, the virus may become resistant to it.

It’s important to take your medicines as prescribed and not miss any pills or appointments.

At these appointments you will have your viral load checked so you know the medicine is working. A viral load result of less than 200 copies/mL lowers the risk of giving HIV to others. You will also need to have regular blood tests.

Side effects from antiretroviral therapy (ART) can vary depending on the medicine and the person taking the medicine. Older treatments had a lot of side effects but ART has improved since then and now has fewer side effects.

People taking the same antiretroviral medications can have very different side effects. Talk to your doctor if your side effects are difficult to manage.

Some side effects, (eg, headache or occasional dizziness), may not be serious.
Other side effects, (eg, swelling of the mouth and tongue or liver damage), can be life-threatening.
Common side effects include nausea (feeling sick), vomiting (being sick), diarrhoea (runny poos), skin rashes and problems sleeping.

Read more about managing side effects(external link).

Antiretroviral medicines can interact with each other, and they can also interact with other medicines prescribed by your doctor or medicines bought over-the-counter. These include herbal remedies such as St John's Wort, as well as recreational drugs.

An interaction can reduce or increase a medicine's effect on the body. Interactions can also cause side effects. Always check with your HIV clinic staff or your GP before taking any other medicines.

HIV and AIDS
Pre-exposure Prophylaxis (PrEP)
Post-exposure prophylaxis (PEP)

The following links provide further information on HIV medicines.

HIV treatment(external link) Burnett Foundation Aotearoa, NZ
HIV medications(external link) Body Positive New Zealand, NZ