Antiretroviral Comparison: Which Drugs Work Best and Why

When it comes to managing antiretroviral therapy, a combination of drugs used to suppress HIV and prevent progression to AIDS. Also known as ART, it’s the standard of care for anyone living with HIV. Choosing the right mix isn’t about picking the most expensive or newest drug—it’s about finding what fits your body, lifestyle, and long-term goals. Not all antiretrovirals work the same way, and side effects, dosing schedules, and drug interactions can make one option far better than another for you.

There are several major classes of antiretroviral drugs, medications that block HIV at different stages of its life cycle. Nucleoside reverse transcriptase inhibitors (NRTIs) like tenofovir and emtricitabine stop the virus from copying its genetic material. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) like efavirenz do something similar but bind differently. Then there are integrase inhibitors like dolutegravir, which prevent HIV from inserting its DNA into your cells—often the first choice today because they’re potent and have fewer side effects. Protease inhibitors and entry inhibitors round out the list, each with their own pros and cons. What you need depends on your viral load, resistance history, other health conditions, and even your daily routine.

Side effects vary wildly. Some people tolerate tenofovir well; others get kidney issues or bone thinning. Dolutegravir might cause insomnia or weight gain in some, while efavirenz can mess with sleep and mood. And let’s not forget drug interactions—some antiretrovirals clash with common meds for cholesterol, depression, or even heartburn. That’s why comparing them isn’t just a list of names and prices. It’s about matching the right combination to your life. You’ll find real comparisons here: how one drug stacks up against another in effectiveness, how often people stop taking them due to side effects, and which ones are easiest to stick with over time. These aren’t theoretical debates—they’re based on what patients actually experience, what doctors see in clinics, and what studies show after years of use. Below, you’ll see detailed breakdowns of specific medications, real-world trade-offs, and insights that help you ask the right questions—whether you’re newly diagnosed or switching regimens.