• Highly Active Antiretroviral Therapy (HAART)

    Initial HAART therapy usually includes two nucleoside reverse transcriptase inhibitors (NRTIs) plus a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI). The newest class of drug used in HAART therapy, fusion inhibitors, prevents fusion of the HIV virus with the target CD4 cell. One drug, Fuzeon (or T-20), has recently been released for use in this class. Information on the generic names of the drugs, their initials and their common side effects with comments is available by clicking on one of the above drug categories.

    The patient's response to therapy is measured by monitoring levels of HIV-RNA, with the goal of maintaining a HIV-RNA level (viral load) of less than 50 viral copies per milliliter (cpm) and increasing the CD4 count over time.

    Long-term toxicity from HAART may include:  

    • Diabetes mellitus
    • Hyperlipidemia (increased LDL and triglycerides)
    • Wasting syndrome (lipoatrophy involving the face and legs)
    • Fat redistribution (e.g., buffalo hump)
    • Hypogonadism
    • Cardiac disease
    • Lactic acidosis
    • Hepatic steatosis
    • Osteoporosis, osteonecrosis, or osteopenia


    These long-term effects need to be monitored carefully by the patient's primary care provider.

    Patients with acute retroviral syndrome who fail their HAART therapy should be considered for HIV drug resistance testing using HIV genotyping and phenotyping. Specific resistance codons to HIV NRTIs, NNRTIs and PIs help clinicians determine the cause of the HAART failure and possibly consider new drugs to include in a HAART regimen. HIV/AIDS patients with a history of injection drug use or transfusions of blood products are also at risk for co-infection with hepatitis C. New antiretroviral drugs that include NRTIs, NNRTIs, PIs, and fusion inhibitors are in development and will be available later this year. Please continue to monitor this Web site as new drugs are developed and released. 

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