Integrase Inhibitors for HIV

Medically reviewed by Andrea Ho, PharmD, MS on August 5, 2016Written by Susan York Morris

HIV and integrase inhibitors

Integrase inhibitors are a part of antiretroviral treatment (ART), which has advanced a long way in a short time. Because of these advances, HIV is now a manageable disease for most people.

Take a look at how HIV infects your body, how integrase inhibitors manage this infection, and how your doctor measures your treatment’s efficacy. You can also find some tips for ensuring the effectiveness of your integrase inhibitor treatment.

Understanding HIV infection

Integrase inhibitors affect the way that HIV works in your body. To get a better understanding, let’s explore HIV infection from the beginning.

HIV is transmitted between people through the exchange of body fluids such as blood, semen, rectal and vaginal fluids, and breast milk. It’s not transmitted through saliva.

Once the virus is in your body, HIV attacks certain white blood cells, called CD4 cells or T-cells. These are the cells that tell your immune system to attack harmful organisms such as viruses and bacteria. HIV inserts itself into these T-cells and takes control of them.

It does this by making an enzyme called integrase. Integrase allows the viral DNA to merge with the DNA in your T-cells. Then, the HIV can control what the cells do. Without treatment, HIV can eventually take over enough of your T-cells. If this happens, your T-cells can no longer signal your immune system to fight certain infections and other diseases, including cancers.

About integrase inhibitors

Integrase inhibitors bank on the fact that HIV needs integrase to replicate. These drugs stop HIV from being able to make integrase. Without the help of this enzyme, HIV can’t take over your T-cells to copy itself. With a combination of other HIV medications, integrase inhibitors can help keep your HIV infection under control.

The FDA approved the use of integrase inhibitors in 2007. The integrase inhibitors currently on the market include:

Usually, integrase inhibitors are used with other drugs, often in one combination pill. The other drugs help interfere with other ways that HIV works. The combined action of these drugs helps stop HIV through many different ways at once. You can learn the benefits of this treatment in Healthline’s article about the single-tablet regimen.

Read more: Understanding the “AIDS cocktail” »

Side effects

Integrase inhibitors have fewer side effects than other HIV drugs because they work on the virus itself, not on your cells. The most common side effects with integrase inhibitors are:

  • diarrhea
  • nausea
  • fatigue
  • headache
  • insomnia

Rarely, some people experience more serious side effects. These can include severe skin reactions and widespread inflammatory response.

If you’re taking an integrase inhibitor and begin to experience uncomfortable side effects, don’t stop taking the drug without talking to your doctor first. Pausing or changing antiretroviral drugs can do more harm than good. The medications may become less effective, or the virus may become resistant to the drugs altogether. You should consult with your HIV doctor about other drug options before stopping or changing a drug regimen. They may be able to offer an alternative.

Measuring your response to therapy

During your treatment for HIV infection, your doctor will periodically test your blood, usually every six months. Two measurements help your doctor know how your integrase inhibitors are working to keep your infection under control. These measurements are your viral load and your T-cell count.

Viral load

Your viral load is the amount HIV in a given sample of your blood. Your doctor sends your blood sample to a lab, where they measure how many HIV copies are in one milliliter of the sample. The lower your viral load, the less HIV you have in your body.

An undetectable viral load is when the copies of HIV in your blood sample are fewer than the smallest amount the lab test can detect. An undetectable viral load does not mean you are cured, though. HIV can still exist in your bodily fluids, so you need to continue HIV treatment.

T-cell counts

A T-cell count measures the number of T-cells you have in one milliliter of your blood. It's a general way to monitor your immune system. Generally speaking, the more T-cells you have, the more protection you have against infections.

An important thing to remember is that the number of T-cells in your body constantly changes. This is true for everyone, even people without HIV infection. Having slightly lower levels of T-cells on one test result doesn’t necessarily mean that your drugs aren’t working. Illness, vaccinations, fatigue, stress, and even the time of day can all affect your T-cell counts.

Pharmacist’s advice

Your integrase inhibitor needs to stay at a consistent level in your body to be most effective. To help ensure your drug works at its best, try these tips:

  • Take your integrase inhibitor exactly as prescribed by your doctor.
  • Don’t take an integrase inhibitor with any other drug without first getting your doctor’s approval.

Other drugs may affect how your HIV drugs work. These include prescription and over-the-counter drugs as well as vitamins and supplements. If you do your part, integrase inhibitors may be able to provide effective long-term management of your HIV infection.

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