First combination

If you are starting anti-HIV treatment for the first time, then UK treatment guidelines recommend that you take the NNRTI efavirenz (Sustiva). Some doctors and people with HIV prefer an efavirenz-based combination because it has relatively few side-effects and is very easy to take.

Nevirapine (Viramune) is an alternative NNRTI in some cases, such as women who are pregnant or thinking of pregnancy, or people with mental health problems.

The main disadvantage of these two NNRTIs is that it is quite easy for HIV to become resistant to them.

Etravirine (Intelence) is another NNRTI. But at the moment its use is reserved for people who have taken a lot of anti-HIV drugs in the past. Etravirine can work well against HIV that is resistant to efavirenz and nevirapine.

Starting treatment with  a ‘boosted’ protease inhibitor is only recommended for certain groups of people in current UK treatment guidelines. 

A boosted protease inhibitor might be a good option for you if are infected with HIV that is resistant to NNRTIs or has a lot of resistance to NRTIs, or if you are pregnant or thinking about becoming pregnant. Efavirenz, the recommended NNRTI, can cause psychiatric side-effects, so a boosted protease inhibitor might be an option if you have a history of depression or mental health problems.

The recommended boosted protease inhibitors for people starting anti-HIV treatment are atazanavir/ritonavir (Reyataz), darunavir/ritonavir (Prezista), Kaletra (lopinavir/ritonavir),  fosamprenavir/ritonavir (Telzir) and saquinavir/ritonavir (Invirase). 

Tipranavir/ritonavir (Aptivus) is only approved for people who've taken a lot of anti-HIV drugs. 

Indinavir can be boosted (although it isn't aproved for use in this way), but is now very rarely used and isn't recommended. The protease inhibitor nelfinavir (Viracept) cannot be boosted by ritonavir and is generally only used for the treatment of HIV in special circumstances.