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The medications that are currently available come in 5 different classes and each works in a different way and oftentimes at different stages of the condition to limit HIV from multiplying. These core classes are Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs), Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs), Protease Inhibitors (PIs), entry inhibitors and integrase inhibitors.NRTIs work to provide defective raw material to HIV as it tries to build replication systems in body cells. An example is Emtriva (emtricitabine). NNRTIs work to provide incorrect blueprints for HIV as it tries to order the replication process. An example is Sustiva (efavirenz). PIs work to provide defective parts to each new HIV as it is assembled. An example is Reyataz (atazanavir). Entry inhibitors work to prevent HIV from entering body cells. An example is Fuzeon (enfuvirtide). Integrase inhibitors work to prevent HIV that has already entered body cells from inserting code into body cell DNA. An example is Isentress (raltegravir).Different combinations of medication from these classes make up the treatment regime known as Highly Active Anti-Retroviral Therapy (HAART).No single combination of medications in HAART has proven to be best for everyone and treatment benefit is often optimized from selecting a suitable combination after having compared the advantages and disadvantages of the medications within the classes involved. The most common class combinations prescribed at the beginning of HIV treatment are either an NNRTI in combination with two NRTIs or the combination of a PPI with two NRTIs. PPIs can act as boosters, increasing the power of the other medications in the treatment regime.The choice of HAART regimen should be discussed in detail with the prescribing doctor and often hinges on several key issues that include how powerful the initial combination is, whether there is preservation of other future combinations should there be resistance to the initially chosen one, what side effects are likely to occur, how many pills need to be taken and how often these pills are to be taken. High cholesterol and poorer blood sugar control have been known to result from taking different PIs, NRTIs and other HIV medications. The newer medications however, may be less likely to contribute to such problems. Most NRTIs also have been known to cause a build up of lactic acid that can result in nausea, vomiting and liver damage. Some NRTIs may damage the nervous system resulting in tingling, burning and numbness in the hands and feet. Many HIV medications cause diarrhea and stomach upset especially at the start of treatment. Depression, anxiety and unusual dreams have been known to occur with NNRTIs and other HIV medications although these usually do not last for long. An experienced HIV specialist is usually the best person to consult with should any unusual symptoms be experienced from taking HIV medication. It is useful to note that the majority of side effects encountered do not last beyond the first 2 months of starting treatment.HAART medications are known to interact with a variety of other non-AIDS medications and such interactions should be discussed if other medications are concurrently taken. Medications in any HAART regime can also be costly especially if they are branded. Generics of such medications can be found in various countries and as they become more available, are a good means of reducing the cost of treatment. Generic AIDS medications often cost only a fraction of their branded counterparts. An experienced HIV medication expert should be consulted and can be invaluable in facilitating the decision on initiating and maintaining a safe and cost-effective medication regime.
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