HIV (A)

=__**Disease/Drug of interest** : __=

**Motivation and Background** :
In the past few decades, the world have undergone an epidemic of many Sexually Transmitted Infections (STIs). Among the most prevalent of these is HIV/AIDS (Human Immunodeficiency Virus/Aquired Immunodeficiency Syndrome), which kills a person’s immune system. HIV reproduces in the body through the catalyst Reverse Transcriptase, which is an enzyme encoded in retroviral RNA. The drugs that are used to combat HIV and AIDS are commonly reverse transcriptase inhibitors, which hinder the HIV virus’ cell division and DNA creation. The reverse transcriptase inhibitor Atripla is among the most popular courses of treatment used in HIV patients today. Much more about HIV is understood in today’s world, but in years as recent as the 1980s, HIV was a taboo disease, and was associated with the gay community (which was also taboo at that point, as homophobia was incredibly prevalent in those decades as well). Up until 1986, HIV was referred to as GRID (Gay-Related Immune Deficiency). Because of this, many people with AIDS or HIV refused to acknowledge their disease, therefore making themselves highly susceptible to the negative consequences of not treating HIV. For example, in the play “Angels of America”, one of the characters had contracted HIV, but would only admit to having “liver disease”, and he subsequently died from lack of proper care, as he would rather die with dignity than claim a disease that had so much social stigma. Fortunately, as scientists and other members of different communities have learned more about this disease, ignorance has faded, and understanding and compassion have taken its place. It’s to the world’s advantage that the research surrounding HIV has allowed it to be more socially acceptable because the HIV/AIDS crisis has become an epidemic throughout the world. The term epidemic is defined by a quick and wide-set audience, and it comes from the Greek phrase epi demos, which means “upon the people or community”. Indeed, HIV has descended upon the people of many countries, ravaging the bodies of children and adults alike. An estimated 1.5 million people around the world die of AIDS related causes every year, which, sadly, is a significant improvement from the peak of mortality rates in 2005. HIV is significantly more prevalent in third-world (poorer) countries, such as those found in Africa and South Asia, due to the lack of access to drugs such as Atripla.

**Figure 1.** Colored map identifying number of cases of HIV infected persons by region.


 * References: **

"Atripla: Efavirenz-emtricitabine-tenofovir, Oral Tablet." Healthline. Deeks, Emma D.; Perry, Caroline M.; Efavirenz/Emtricitabine/Tenofovir Disoproxil Fumarate Single-Tablet Regimen (Atripla®): A Review of its Use in the Management of HIV Infection Adis Drug Evaluation 2010, 70, (17), 2324-34 "Efavirenz / Emtricitabine / Tenofovir Disoproxil Fumarate (Atripla)." AIDSinfo. National Institute of Health, 2016. "How Atripla Works." Bristol-Myers Squibb & Gilead Sciences Horberg, Michael A.; Klein, Daniel B., An update on the use of Atripla on the treatment of HIV in the United States Dove Press 2010, 2, 135-40 Morier, Douglas. Reverse Transcriptase Enzyme. Encyclopedia Britannica. 2014.

**External links:**
=__**Target Information** : __=



** Figure 2. ** Reverse transcriptase, showing subunits and their respective weights.

** Size ** : molecular weight of the protein
Reverse transcriptase is made up of two subunits, which are 66 kilodaltons and 51 kilodaltons respectively.

** Location ** :
Reverse Transcriptase is not naturally found in humans, but is actually encoded in retroviral RNA.

** Function in a normal cell ** :
none

=__**Drug Information**** : **__=


 * Schematic figure of drug ** :


 * Figure 3.** Schematic figure of Atripla mixture


 * Formula ** :

Because it’s a mixture, it’s chemical makeup contains separate parts, so the molecular formula is written as the combination C 19 H 30 N 5 O 10 P. C 14 H 9 Cl F 3 N O 2. C 8 H 10 F N 3 O 3 S. C 4 H 4 O 4.


 * Molecular weight ** :

Atripla is actually a combination of three drugs: Efavirenz, Emtricitabine, and Tenofovir Disoproxil Fumarate. Their molecular weights are 315.68 g/mol, 247.24 g/mol, and 653.52 g/mol respectively.


 * CAS Number ** :

731772-50-2.


 * Delivery method ** :

Atripla is a pill taken orally once a day


 * Side effects ** :

Atripla’s side effects include high cholesterol, hypertension, rashes, changes in metabolism, liver disease, decreased kidney function, broken bones, headaches, gastrointestinal problems, and mood changes (which is why Atripla is not commonly recommended for patients with depression and/or anxiety, as it may aggravate the condition).


 * Other names ** :

Efavirenz-emtricitabine-tenofovir disoproxil fumarate mixt.


 * Maker or company ** :

Bristol-Meyers Squibb and Gilead Sciences


 * Is it patented ** ?

yes


 * Clinical Trials Info ** :

Atripla has been successful in over 50 clinical trials.

__** Origin ** : __


 * Alternatives to this drug ** :

There are many drug alternatives such as Abacavir, [|Combivir], Complera, Didanosine, [|Emtriva] , Entecavir, [|Epivir] , [|Epzicom] , [|Retrovir] , [|Trizivir] , [|Truvada] , [|Videx] , Videx EC, [|Viread] , [|Zerit] , and Ziagen.


 * Miscellaneous ** :


 * Other uses ** : can this drug be used to treat other diseases/conditions?

Atripla is used in HIV treatment as well as to treat other diseases such as Hepatitis B, because it is a reverse transcriptase inhibitor.