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NURS 6521: Advanced Pharmacology Human immunodeficiency virus (HIV) is a chronic virus that is contracted by exposure tobodily fluid through sexual intercourse, blood-borne contact, perinatal transmission, or breastfeeding (Arcangelo, Peterson, Wilbur, & Reinhold, 2017; Centers for Disease Control and Prevention [CDC], 2019). HIV, if left untreated, will progress to acquired immunodeficiency syndrome (AIDS) in an average of ten years; however, this time frame varies significantly among individuals that do not receive treatment (Arcangelo et al., 2017). HIV targets the body’s immune system, specifically CD4 cells or T lymphocytes; HIV destroys so many of these cells that it compromises the bodies ability to fight off infection and disease (CDC, 2019). Two types of HIV have been identified as HIV-1 and HIV-2; HIV-1 is the cause of most of the cases worldwide, including the United States (U.S.) and HIV-2 is mainly found in West Africa (Arcangelo et al., 2017). Drugs to Treat HIV/AIDSAll patients diagnosed with HIV should be offered ART treatment regardless of the CD4 count; effective ART decreases the risk of sexual transmission of HIV (Arcangelo et al., 2017). The goal of drug therapy is focused on suppressing viral replication to undetectable levels because no ART regimen can completely eradicate the virus. There are several classes of drugs that are used to treat HIV. Medications used to treat HIV include nucleoside reverse transcriptaseinhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), fusion inhibitors, integrase inhibitors (INSTIs), and CCR5 antagonists (Arcangelo et al., 2017). Guidelines are available for the combination of agents in ART; however, each patient requires an individualized treatment regimen (Arcangelo et al., 2017). An individual’s initial
HIV regimen generally includes three HIV medications from at least two different drug classes (U.S. Department of Health and Human Services [DHHR], 2019a). NRTIs block reverse transcriptase, an enzyme required by HIV to replicate; common NRTIs include abacavir, emtricitabine, lamivudine, tenofovir disoproxil, and zidovudine (DHHR,2019a). NNRTIs also acts on reverse transcriptase by binding to and later altering the enzyme; NNRTIs include doravirine, efavirenz, etravirine, nevirapine, and rilpivirine (DHHR, 2019a).