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Guides Introduction to combination therapy

Main types of HIV drugs

There are six main types of drugs that work at different parts of the HIV lifecycle.

RTIs or nukes Reverse transcriptase inhibitors – also called nucleoside or nucleotide analogues
NNRTIs Non-nucleoside reverse transcriptase inhibitors or non-nukes
PIs Protease inhibitors
Fusion inhibitors Fusion inhibitors are a type of entry inhibitor
CCR5 inhibitors CCR5 inhibitors are a type of entry inhibitor
INIs Integrase inhibitors

Within each class, only a few drugs or combinations are recommended.

Even though there are over 26 HIV drugs and hundreds of potential choices, only two main types of combination are recommended.

First combination meds

UK guidelines include starting treatment with two nukes plus a third drug.

The 2012 draft recommendations are summarised below.

Guidelines recommend starting with either:

Preferred Alternative
Two ‘nukes’ tenofovir + FTC (Truvada) abacavir + 3TC (Kivexa)
Plus a third drug efavirenz (NNRTI) or

atazanavir/r (boosted PI)  or

darunavir/r (boosted PI)  or

raltegravir (integrase inhibitor)

lopinavir/r (boosted PI)  or

fosamprenavir/r (boosted PI)  or

nevirapine (NNRTI) or

rilpivirine (NNRT



April 2012

Decisions relating to your treatment should always be taken in consultation with your doctor. Information in this guide is intended to support those discussions.

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