Treatment training manual

3. 3 What is ART?

Antiretroviral therapy (ART) is the term for treatment that uses three or more ARVs to treat HIV.

ARV stands for antiretroviral. This is because HIV is a retrovirus.

ART is also called:

  • Combination therapy.
  • ARV therapy.
  • Triple therapy.
  • cART (combination antiretroviral therapy).
  • HAART (highly active antiretroviral therapy).

In many ways HIV is difficult to treat. This is because the virus reproduces very quickly and in large quantities. If treatment is not strong enough or if doses of medication are missed, then drug resistance can easily develop.

Combination treatment works because there are usually at least three different drugs actively fighting the virus. If some of your virus is resistant to one drug, the other drugs might still suppress it.

If you miss doses or are late taking HIV drugs, then they may not work at all, or will only work for a few months.

Some studies have looked at whether one boosted drug could be strong enough to control HIV. These are studies using a class of drugs called protease inhibitors (PIs). Some people use one protease inhibitor boosted by ritonavir (another PI) as combination therapy. Only some PIs can be used in this way.

For some people this is almost as good as triple therapy combinations, but it is not quite as good. For this reason, boosted PI monotherapy is not recommened in most guidelines.

In October 2015, very early results were reported from several studies using dolutegravir as single therapy, or as dual therapy with another ARV like lamivudine (3TC).

These studies produced very surprising results. They showed that viral load stayed undetectable for up to 6 months. An important note is that these results were only in people who had never used integrase inhibitors in previous combinations.

Further research in larger studies is needed to understand why dolutegravir appears to be different to all other drugs. This has exciting implications for future treatment.

Last updated: 1 January 2016.