HIV treatment involves a combination of medicines known as antiretroviral therapy, or ART. Because these medicines have long chemical names and are often referred to by abbreviations, the list can look complicated at first glance. This guide sets out the main ART medicines commonly used in India, grouped by the class each one belongs to.
The purpose here is orientation rather than instruction. Knowing which medicine belongs to which class makes conversations with a treating doctor easier to follow, and helps explain why treatment usually combines more than one medicine.
| Important note This article is general information about medicines used in HIV care. It does not include dosing instructions and is not a substitute for medical advice. All HIV medicines are prescription-only and are selected, started, and changed by a qualified doctor. |
Quick Summary / Key Takeaways
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HIV multiplies by copying itself inside certain immune cells. Each class of ART medicine interrupts a different step in that process. Combining classes blocks the virus at several points at once, which is far more effective than a single medicine and helps prevent the virus from adapting over time. The underlying principle is explained in what is ART (antiretroviral therapy).
| Class | What it does | Examples used in India |
|---|---|---|
| NRTIs (nucleoside reverse transcriptase inhibitors) | Block the copying of viral genetic material | Tenofovir (TDF and TAF), lamivudine, emtricitabine, abacavir, zidovudine |
| NNRTIs (non-nucleoside reverse transcriptase inhibitors) | Block the same enzyme in a different way | Efavirenz, nevirapine, doravirine, rilpivirine |
| INSTIs (integrase inhibitors) | Stop the virus inserting itself into cell DNA | Dolutegravir, bictegravir, raltegravir |
| PIs (protease inhibitors) | Prevent new viral particles maturing | Darunavir, atazanavir, lopinavir |
| Boosters | Raise levels of certain medicines so they work effectively | Ritonavir, cobicistat |
Integrase inhibitors are recommended as the preferred anchor medicine in current World Health Organization guidance, because they are effective, generally well tolerated, and hold up well against resistance. Dolutegravir is the most widely used member of this class in India.
Most regimens pair two NRTIs together as a backbone, most often tenofovir with lamivudine or emtricitabine. These medicines form the foundation on which an integrase inhibitor or another anchor medicine is added. Together they create a combination that suppresses the virus from several angles.
NNRTIs such as efavirenz and nevirapine were once the standard anchor medicines and are still used in particular situations. Protease inhibitors, including darunavir and atazanavir, are mainly used when a change of regimen is needed. A treating doctor decides when these classes are appropriate for an individual.
Rather than several separate tablets, many regimens are supplied as one tablet containing more than one medicine. These are called fixed-dose combinations. Widely used examples include:
The same medicine can appear under several brand names while the active ingredient stays the same. India produces a large share of the worldโs generic ART, which is one reason treatment is widely accessible here. For more on how generic and branded versions compare, see generic vs branded ART in India, and for pricing, see HIV medicine cost in India.
| Myth | Fact |
|---|---|
| A longer list of tablets means stronger treatment. | Most modern regimens are a single daily tablet and work very well. |
| Every person receives the same medicines. | Regimens are selected individually by a doctor. |
| Generic versions contain different ingredients. | Generic and branded versions contain the same active ingredients. |
| Medicines can be chosen from a list without a prescription. | All ART medicines are prescription-only and require medical assessment. |
| Older medicines are no longer used at all. | Some remain useful in specific situations decided by a doctor. |
| When to Consult a Doctor A doctor should be consulted before starting any HIV medicine, and before any change to an existing regimen. Medical advice is also appropriate where side effects appear, where other medicines are being taken alongside ART, or where questions arise about a particular medicine on this list. Support is available through HIV treatment and ART care. |
The list of ART medicines becomes far more manageable once the classes are clear. NRTIs form the backbone of most regimens, integrase inhibitors such as dolutegravir act as the preferred anchor, and NNRTIs and protease inhibitors have their own defined places. Modern treatment often brings these together in a single daily tablet, selected for each person by a treating doctor.
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The main classes are NRTIs, NNRTIs, integrase inhibitors, and protease inhibitors, along with boosters that raise the levels of certain medicines. Each class interrupts a different step in the way HIV copies itself.
Tenofovir, lamivudine, and dolutegravir are among the most widely used, often combined in a single tablet known as TLD. Other medicines include emtricitabine, abacavir, zidovudine, efavirenz, nevirapine, darunavir, and atazanavir.
Combining medicines from different classes blocks HIV at several stages at once. This is more effective than a single medicine and helps prevent the virus from adapting to treatment over time.
TLD refers to a fixed-dose combination containing tenofovir, lamivudine, and dolutegravir in one tablet. It is among the most widely used first-line combinations internationally and in India.
Current World Health Organization guidance recommends dolutegravir-based regimens as the preferred option for first-line and subsequent treatment, reflecting effectiveness, tolerability, and a high barrier to resistance.
No. The same active ingredient may be sold under several brand names. Generic and branded versions contain the same active ingredients and are expected to work in the same way.
No. All ART medicines are prescription-only. A doctor selects a regimen after assessment, taking into account overall health, other medicines, and individual circumstances.
Some older medicines remain useful in specific situations, although newer options are generally preferred. The choice in any individual case is made by the treating doctor.
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