HIV Therapy & Antivirals – First Aid 2025 (High-Yield Summary)

A set of vocabulary-style flashcards covering HIV therapy classes, antiviral drugs, MOAs, uses, and key adverse effects as described in the notes.

Zidovudine (AZT)

NRTI that competitively inhibits nucleotide binding to reverse transcriptase → terminates DNA synthesis; used for HIV; ZDV also used for pregnancy prophylaxis; SE: bone marrow suppression.

Lamivudine (3TC)

NRTI active against HIV; also active against HBV; SE: lactic acidosis risk is a class effect (noted in NRTIs generally).

Emtricitabine (FTC)

NRTI active against HIV; also active against HBV; SE: lactic acidosis risk (class effect).

Abacavir (ABC)

NRTI; hypersensitivity reaction associated with HLA-B*57:01 allele; screen before use.

Didanosine (DDI)

NRTI; SE: peripheral neuropathy, pancreatitis, lactic acidosis.

Stavudine (d4T)

NRTI; SE: peripheral neuropathy, lactic acidosis, pancreatitis.

Tenofovir (TDF/TAF)

NRTI with activity against HIV; also active against HBV; used in HIV therapy; (HBV activity noted in notes).

Efavirenz (EFV)

NNRTI; MOA: binds reverse transcriptase at a different site, does not require activation; Use: HIV; SE: vivid dreams, CNS effects; contraindicated in pregnancy.

Nevirapine (NVP)

NNRTI; MOA: binds reverse transcriptase; SE: rash, hepatotoxicity.

Delavirdine (DLV)

NNRTI; MOA: binds reverse transcriptase; SE: rash; contraindicated in pregnancy.

Lopinavir (LPV)

PI; MOA: inhibits HIV-1 protease → prevents maturation; Use: HIV; SE: hyperglycemia, GI intolerance, lipodystrophy.

Atazanavir (ATV)

PI; MOA: inhibits HIV-1 protease; SE: hyperglycemia, GI intolerance, lipodystrophy; may require boosting with ritonavir.

Darunavir (DRV)

PI; Use: HIV; SE: hyperglycemia, GI intolerance, lipodystrophy.

Indinavir (IDV)

PI; SE: nephrolithiasis.

Ritonavir (RTV)

PI; used mainly as pharmacokinetic booster due to CYP450 inhibition; SE: CYP450 interactions; GI intolerance.

Raltegravir (RAL)

Integrase inhibitor; MOA: inhibits HIV genome integration into host DNA; SE: ↑ CK, myopathy, hepatotoxicity, weight gain.

Elvitegravir (EVG)

Integrase inhibitor; MOA: inhibits HIV genome integration; SE: CK elevation, hepatotoxicity; often boosted (e.g., with cobicistat).

Dolutegravir (DTG)

Integrase inhibitor; MOA: inhibits integration; SE: CK elevation, hepatotoxicity, weight gain.

Bictegravir (BIC)

Integrase inhibitor; MOA: inhibits integration; SE: CK elevation, hepatotoxicity, weight gain.

Enfuvirtide (T-20)

Fusion inhibitor; MOA: binds gp41 to inhibit viral entry; Use: HIV salvage therapy; SE: injection-site skin reactions.

Maraviroc (MVC)

CCR5 antagonist; MOA: binds CCR5 → blocks gp120 entry; Use: HIV only with CCR5-tropic virus; SE: hepatotoxicity.

Acyclovir (ACV)

Guanosine analog activated by viral thymidine kinase; inhibits viral DNA polymerase; Use: HSV, VZV; SE: crystalline nephropathy, AKI.

Valacyclovir (VCV)

Prodrug of acyclovir; MOA/Use similar to acyclovir; SE: similar (crystalline nephropathy risk).

Famciclovir (FCV)

Prodrug of penciclovir; Use: HSV, VZV; especially effective for shingles; SE: similar to acyclovir-based therapies.

Ganciclovir (GCV)

Guanosine analog activated by viral kinase; inhibits viral DNA polymerase; Use: CMV; SE: bone marrow suppression, renal toxicity.

Valganciclovir (VGCV)

Oral prodrug of ganciclovir; MOA/Use similar to GCV; SE: bone marrow suppression, renal toxicity.

Foscarnet (Foscarnet)**

Pyrophosphate analog; inhibits viral DNA polymerase; no phosphorylation required; Use: CMV retinitis (resistant), acyclovir-resistant HSV; SE: nephrotoxicity, electrolyte abnormalities.

Cidofovir (CDV)

Nucleotide analog; inhibits viral DNA polymerase; Use: CMV retinitis, acyclovir-resistant HSV; SE: nephrotoxicity; coadmin with probenecid/IV saline.

Oseltamivir (OCV)

Neuraminidase inhibitor; MOA: prevents release of progeny virions; Use: Influenza A and B; treat within 48h; SE: Nausea.

Zanamivir (ZMV)

Neuraminidase inhibitor; MOA: prevents release of virions; Use: Influenza A and B; treat within 48h; SE: Nausea, bronchospasm (inhaled form).

Ribavirin (RBV)

Nucleoside analog; inhibits guanine nucleotide synthesis and viral RNA polymerase; Use: Chronic HCV with IFN, RSV (rare); SE: Hemolytic anemia, teratogen.

Sofosbuvir (SOF)

NS5B RNA-dependent RNA polymerase inhibitor; chain terminator; Use: Chronic HCV (with ribavirin and/or ledipasvir/velpatasvir); SE: Fatigue, headache, nausea.

Ledipasvir (LED)

NS5A inhibitor; Use: Chronic HCV (in combination therapy); SE: Headache, diarrhea.

Velpatasvir (VEL)

NS5A inhibitor; Use: Chronic HCV (in combination therapy); SE: Headache, diarrhea.

Interferons (IFN-α/IFN-β/IFN-γ)

Glycoproteins produced in response to viral infection with antiviral/antitumor activity; IFN-α: chronic HBV, HCV, Kaposi, HPV warts; IFN-β: multiple sclerosis; IFN-γ: CGD; SE: flu-like symptoms, depression, neutropenia, myopathy.