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Treatment of HIV illness with antiretroviral medications is aimed at suppressing viral replication and preventing deterioration of the immune system. The emergence of drug-resistant HIV during therapy remains a major challenge to treatment. HIV has a high spontaneous mutation rate, and emergence of drug resistance during treatment is frequent. The achievement of viral suppression necessitates a combination of antiretroviral agents, each with different mechanisms of action. There are four main categories of antiretroviral medications, each with numerous side effects, including behavioral and cognitive side effects (Table 32–3).

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TABLE 32–3. Antiretroviral medication classes and neuropsychiatric side effects

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