Currently (May 2018) there are 22 types of drugs indicated to inhibit the advance of the HIV virus on the CD4 cells of the immune system. Are they:
Nucleoside Reverse Transcriptase Inhibitors – Abacavir (ABC), Didanosine (ddI), Lamivudine (3TC), Tenofovir (TDF), Zidovudine (AZT)
Non-Nucleoside Reverse Transcriptase Inhibitors Efavirenz (EFZ), Nevirapine (NVP), Etravirine (ETR)
Protease Inhibitors – Atazanavir (ATV), Darunavir (DRV), Fosamprenavir (FPV), Lopinavir (LPV), Nelfinavir (NFV), Ritonavir (RTV), Saquinavir (SQV), Tipranavir (TPV)
Fusion Inhibitors – Enfuvirtide (T20)
Integrase Inhibitors – Dolutegravir (DTG), Raltegravir (RAL)
Entry Inhibitors – Maraviroc (MRV)
Drug combinations – Lamivudine + Zidovudine (3TC + AZT) combined; Lamivudine + Tenofovir + Efavirenz (3TC + TDF + EFZ) combined
Compounds and dosage vary according to the stage of the disease. A patient in the early stages of AIDS takes three medications a day, but the bill can triple if he is very weak.
“When HIV invades the cell, the virus alters its genetic material, compromising its functioning and the body’s immunity, which ends up being vulnerable to opportunistic diseases”, explains Marise Fonseca, infectologist and professor at UFMG. “The cocktail does not cure the disease, as it does not eliminate HIV from the body. It acts at different stages of the virus invasion of defense cells, reducing its reproduction intensity”, clarifies Rodrigo Zilli, infectopediatrician and technical advisor of the Department of STD/Aids/Viral Hepatitis of the Ministry of Health.
During the Lula government, our country broke the patent on imported (and expensive!) Efavirenz, used by almost 80% of patients starting treatment. In addition to starting to manufacture the medicine on its own, Brazil has also been using generics to compose the cocktail.
An option to circumvent the prices of medicines distributed free by the federal government to the approximately 200,000 HIV carriers in the country. According to Law No. 9,313, enacted on November 13, 1996, every person with HIV can receive all the medication necessary for their treatment free of charge from the SUS.
GOOD DRUGS
Know some of the main drugs that try to inhibit the expansion of the virus in the body
– (Reproduction/dissemination and Getty images/)
TENOFOVIR
Inhibits cellular DNA alteration by HIV. It was approved in 2001, in the USA, and started to be made available by the Brazilian Unified Health System (SUS) in 2003. In 2010, a vaginal gel with tenofovir was tested in African women, proving to be effective in reducing contagion.
LAMIVUDINE
It serves to prevent the RNA of the virus from integrating into cellular DNA and was approved in 1995 to act in conjunction with zidovudine (AZT). It began to be offered by the SUS in 1999. Preference is given to joint therapy, since the combination of the two drugs increased the success of the treatment.
DARUNAVIR
This medicine works by inhibiting an enzyme called protease, stopping the production of new cells infected with the virus. But it can cause side effects like nausea and headache.
RALTEGRAVIR
This is an integrase inhibitor. It prevents the genetic material of the virus from binding to that of the cell. It is a relatively new drug, approved in 2007. In December 2011, its use was authorized for the treatment of patients aged 2 to 18 years. Side effects include diarrhea, nausea, and fatigue.
RITONAVIR
It is also a protease inhibitor that must be taken every 12 hours. To enhance the treatment, the patient should try to live as healthy a life as possible, avoiding alcohol, tobacco and other drugs that may interfere with the action of the medications in the cocktail.
ENFUVIRTIDA
It is a fusion inhibitor, preventing HIV from entering a healthy cell. The drug is dissolved in water and administered subcutaneously (under the skin), with an injection in the belly, arm or leg. It is suggested that it be applied to areas with more fat, to avoid pain and allergic reactions.