Highly Active Antiretroviral Therapy (HAART): Principles, Drug Classes, Adverse Effects, and Drug Interactions

Introduction

Highly Active Antiretroviral Therapy (HAART) is the cornerstone of HIV treatment, dramatically improving survival rates and quality of life for patients.

Principles of HAART

• Combination therapy to suppress HIV replication
• Prevent drug resistance
• Restore and maintain immune function
• Reduce HIV-related morbidity and mortality

Antiretroviral Drug Classes

1. Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

Block reverse transcriptase enzyme to prevent viral replication (e.g., Zidovudine, Lamivudine).

2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Bind directly to reverse transcriptase (e.g., Efavirenz, Nevirapine).

3. Protease Inhibitors (PIs)

Prevent virus maturation (e.g., Ritonavir, Lopinavir).

4. Integrase Strand Transfer Inhibitors (INSTIs)

Block viral DNA integration into host genome (e.g., Raltegravir, Dolutegravir).

5. Entry Inhibitors

Prevent viral entry into host cells (e.g., Maraviroc, Enfuvirtide).

Adverse Effects

• Gastrointestinal disturbances
• Hepatotoxicity
• Metabolic complications
• Lipodystrophy syndrome
• Neuropathy

Drug Interactions

HAART drugs can interact with other medications, leading to altered efficacy or toxicity.

• Cytochrome P450 enzyme interactions (PIs and NNRTIs)
• Effects on renal clearance
• Interactions with herbal supplements and over-the-counter medications

Emerging Trends in HAART

New drugs, long-acting formulations, and personalized therapy approaches are shaping the future of HIV treatment.

Conclusion

HAART remains a vital strategy in combating HIV/AIDS, requiring careful drug selection and management to maximize patient outcomes.