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Antiretrovirals, Part 1: Overview, History, and Focus on Protease Inhibitors

From the Department of Medicine, Walter Reed Army Medical Center; and the Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine, Bethesda, Md. (Drs. Wynn, Zapor, Smith, Wortmann, and Cozza). Dr. Oesterheld is the Medical Director of the Spurwink School, Portland, Me., and an Instructor of the Family Medicine Program at the University of New England School of Osteopathy, Biddeford, Me. Dr. Armstrong is the Co-Medical Director, Center for Geriatric Psychiatry, Tuality Forest Grove Hospital, Forest Grove, Ore., and Associate Clinical Professor of Psychiatry, Oregon Health Sciences University, Portland, Ore. Drs. Cozza, Armstrong, and Oesterheld are co-authors of the Concise Guide to Drug Interaction Principles for Medical Practice: Cytochrome P450s, UGTs, P-glycoproteins, 2nd edition. (American Psychiatric Publishing, Inc., 2003). Address all correspondence to Dr. Cozza, Psychiatrist, Infectious Disease Service, Ward 63, Department of Medicine, Walter Reed Army Medical Center, 6900 Georgia Ave., Washington, DC 20307-5001; kelly.cozza{at}na.amedd.army.mil (e-mail).
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

ABSTRACT

This column is the first in a series on HIV/AIDS antiretroviral drugs. This first review summarizes the history of HIV/AIDS and the development of highly active antiretroviral therapy (HAART) and highlights why it is important for non-HIV specialists to know about these drugs. There are four broad classes of HIV medications used in varying combinations in HAART: the protease inhibitors, nucleoside analogue reverse transcriptase inhibitors, the non-nucleoside reverse transcriptase inhibitors, and cell membrane fusion inhibitors. This paper reviews the mechanism of action, side effects, toxicities, and drug interactions of the protease inhibitors.

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