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First combination
NNRTI-based
An NNRTI should be taken with a combination of two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs). Either:
However, AZT has been associated with body shape changes and your doctor should discuss the risks of these occurring, and side-effects which abacavir and tenofovir can cause, before you decide which drugs to take.
The reason why some doctors and people with HIV often prefer an NNRTI-based combination is that it has relatively few side-effects and is very easy to take. However, it is very easy to develop resistance to NNRTIs, and if you become resistant to one it’s unlikely you’ll benefit from using any of the currently available NNRTIs.
Protease inhibitor-based
You can also take a first anti-HIV combination that is based on protease inhibitors. However, if you do take a protease inhibitor as part of your first treatment regimen, it should be a ‘boosted’ protease inhibitor. The addition of the small dose of ritonavir boosts blood levels of the drug, meaning that it has a more powerful anti-HIV effect and you have to take fewer pills, which might make your combination easier to adhere to.
Boosted protease inhibitors include a small dose of the protease inhibitor ritonavir (Norvir). If you choose to take a boosted protease inhibitor it is likely that your doctor will recommend that you takeKaletra (lopinavir/ritonavir). Other options are fosamprenavir/ritonavir (Telzir) and hard gel saquinavir/ritonavir (Invirase). At the moment, there is not enough evidence for tazanavir/ritonavir (Reyataz) to be recommend for first-line treatment.
Most British doctors think that it is probably best to start with a combination that involves a non-nucleoside reverse transcriptase inhibitor (NNRTI), or a boosted protease inhibitor.
An NNRTI should be taken with a combination of two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs). Either:
- tenofovir/FTC (available in a combination pill, Truvada)
- abacavir/3TC (available in a combination pill, Kivexa)
- AZT/3TC (available in a combination pill, Combivir)
However, AZT has been associated with body shape changes and your doctor should discuss the risks of these occurring, and side-effects which abacavir and tenofovir can cause, before you decide which drugs to take.
The reason why some doctors and people with HIV often prefer an NNRTI-based combination is that it has relatively few side-effects and is very easy to take. However, it is very easy to develop resistance to NNRTIs, and if you become resistant to one it’s unlikely you’ll benefit from using any of the currently available NNRTIs.
Protease inhibitor-based
You can also take a first anti-HIV combination that is based on protease inhibitors. However, if you do take a protease inhibitor as part of your first treatment regimen, it should be a ‘boosted’ protease inhibitor. The addition of the small dose of ritonavir boosts blood levels of the drug, meaning that it has a more powerful anti-HIV effect and you have to take fewer pills, which might make your combination easier to adhere to.
Boosted protease inhibitors include a small dose of the protease inhibitor ritonavir (Norvir). If you choose to take a boosted protease inhibitor it is likely that your doctor will recommend that you takeKaletra (lopinavir/ritonavir). Other options are fosamprenavir/ritonavir (Telzir) and hard gel saquinavir/ritonavir (Invirase). At the moment, there is not enough evidence for tazanavir/ritonavir (Reyataz) to be recommend for first-line treatment.
Most British doctors think that it is probably best to start with a combination that involves a non-nucleoside reverse transcriptase inhibitor (NNRTI), or a boosted protease inhibitor.