Integrase Inhibitors for HIV

Examples
Brand NameGeneric NameChemical Name
Isentress raltegravir  

Raltegravir is available as pills. Usually, a pill is taken twice a day.

How It Works

Raltegravir blocks the HIV integrase enzyme. This prevents HIV from multiplying. When the amount of virus in the blood is kept at a minimum, the immune system has a chance to recover and grow stronger.

Why It Is Used

Raltegravir is used in combination with other antiretroviral medicines to treat HIV. It helps prevent the virus from spreading in the body and helps reduce the amount of virus in your blood (viral load). Raltegravir may be effective for people who have taken other anti-HIV drugs without success.

The use of three or more antiretroviral medicines (highly active antiretroviral therapy, or HAART) is the usual treatment for HIV infection.

The combination of medicines used for HAART will depend on your health, other conditions you might have (such as hepatitis), and results of testing. Talk to your doctor about the best treatment plan for you.

Treatment guidelines suggest the following for people with HIV:1, 2, 3

  • When considering treatment, experts currently consider your CD4+ cell count and the presence or absence of symptoms more important than your viral load.
  • If your CD4+ cell count is below 500 cells per microliter (mcL), treatment is recommended to help keep your immune system healthy and to prevent AIDS.
  • If your CD4+ cell count is greater than 500, you may want to consider treatment.
  • If treatment is not started, your condition will be monitored with frequent CD4+ cell counts.
  • If you have symptoms of HIV or AIDS, doctors recommend starting treatment, whatever your CD4+ cell count is.
  • If you are pregnant, you should be treated to prevent your unborn baby (fetus) from becoming infected with HIV.
  • If you also have hepatitis B and are starting treatment for it, you should begin treatment for HIV as well.

You may also want to start HIV treatment if your sexual partner does not have HIV. Treatment of your HIV infection can help prevent the spread of HIV to your sexual partner.3

Click here to view a Decision Point.HIV: When Should I Start Antiretroviral Medicines for HIV Infection?
Click here to view an Actionset.HIV: Taking Antiretroviral Drugs

How Well It Works

Raltegravir works well with other antiretroviral medicines to improve CD4+ cell counts and reduce viral load.4, 5

Side Effects

The most common side effects of raltegravir include diarrhea, nausea, headache, and fever.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

The U.S. Food and Drug Administration (FDA) approved raltegravir for people who have already been taking other anti-HIV medicines. It is not approved for use by people who are just starting drug treatment for HIV infection.

Raltegravir should be used to treat a pregnant woman only if the potential benefit is greater than the risk to the unborn baby (fetus).

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. U.S. Department of Health and Human Services (2009). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Available online: http://www.aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf.

  2. Hammer, Scott M, et al. (2008). Antiretroviral treatment of adult HIV infection: 2008 recommendations of the International AIDS Society USA Panel. JAMA, 300 (5): 555–570.

  3. U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents (2011). Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. Available online: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.

  4. Steigbigel RT, et al. (2008). Raltegravir with optimized background therapy for resistant HIV-1 infection. New England Journal of Medicine, 359(4): 339–354.

  5. Cooper DA, et al. (2008). Subgroup and resistance analyses of raltegravir for resistant HIV-1 infection. New England Journal of Medicine, 359(4): 355–365.

By: Healthwise StaffLast Revised: May 18, 2011
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Peter Shalit, MD, PhD - Internal Medicine

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