Antiretroviral drugs (ARVs) are the medicines used to control HIV. They don't cure HIV, but they stop the virus from multiplying, protect your immune system, and make you much less likely to pass the virus to others. If you're new to this, the amount of drug names and classes can feel overwhelming — here's a plain, useful rundown.
ARVs target different steps in the HIV life cycle. Doctors usually combine drugs from different classes to keep the virus suppressed and reduce resistance. The common classes are:
- NRTIs (nucleoside reverse transcriptase inhibitors): tenofovir, lamivudine, emtricitabine, zidovudine. They block the enzyme HIV uses to copy its genetic code.
- NNRTIs (non-nucleoside reverse transcriptase inhibitors): efavirenz and others. They also stop that copying enzyme but in a different way.
- PIs (protease inhibitors): atazanavir, darunavir. These stop the virus from maturing into infectious particles.
- INSTIs (integrase strand transfer inhibitors): dolutegravir, raltegravir. They block the step where viral DNA integrates into your cells.
- Entry/fusion inhibitors and CCR5 antagonists: enfuvirtide and maraviroc. They stop HIV from entering your cells.
Many modern regimens use two NRTIs plus an INSTI because this combo is potent, well tolerated, and simple to take.
Side effects vary by drug. You might get nausea, headaches, sleep changes, kidney or bone effects (some tenofovir forms), or changes in cholesterol and blood sugar with certain drugs. Most side effects ease after a few weeks. Your clinic will check viral load, CD4, kidney and liver tests so problems are caught early.
Missing doses raises the risk of resistance. Try to take pills at the same time every day. If a dose is missed, follow your clinic's advice — don’t double up unless told to. Also: many ARVs interact with other medicines and supplements. Antacids or mineral supplements can reduce absorption of some integrase drugs. St. John's wort can lower levels of certain ARVs. Tell your provider about all medicines, including OTCs and herbs.
If you’re buying meds online, be careful. Look for pharmacies with a physical address, licensed pharmacists, and clear contact info. Avoid deals that look too good — counterfeit or substandard meds are a real risk.
Finally, talk openly with your healthcare team. If side effects are bothersome or you worry about costs or access, there are usually alternative regimens and support programs. Staying informed and connected to care is the single best thing you can do to keep HIV under control.
