Antiretrovirals (ARVs)
nucleoside reverse transcriptase inhibitor NRTI-Antiretrovirals (ARVs) non- nucleoside reverse transcriptase inhibitor-NNRTI-Antiretrovirals (ARVs) protease inhibitors - PI-Antiretrovirals (ARVs) entry inhibitors-EI-Antiretrovirals (ARVs) integrase strand transfer inhibitor-INSTI-Antiretrovirals (ARVs)
NRTI, nucleoside/tide reverse transcriptase inhib; NNRTI, nonnucleoside RTI; PI, protease inhib; EI, entry inhib (CCR5 antagonist); INSTI, integrase inhib; several multiclass combo pills exist
- Initiation of ARVs may transiently worsen existing OIs (TB, MAC, CMV, others) due to immune reconstitution inflammatory syndrome (IRIS). Prednisone during 1st 4 wks of ARVs ↓ risk for TB-associated IRIS, but not routinely given (NEJM 2018;379:1915).
- Do not start ARVs immediately if c/f cryptococcal or TB meningitis
- After ARV initiation, check VL q4 wks until undetectable, then monitor q3–4 mos