Are all non-thymidine analogue backbones appropriate for treating antiretroviral-naïve patients?
An increasing number of antiretroviral agents are available for the treatment of HIV infection. Many clinicians and patients prefer once-daily therapy, and this, in addition to accumulating evidence of toxicity associated with thymidine analogues, means many individuals commence a non-thymidine analogue-based regimen. Stavudine (d4T) is no longer recommended for initial therapy, and zidovudine (AZT) may also be associated with lipoatrophy. Despite investigations into nucleoside-sparing options, triple agent therapy with two nucleoside analogues [nucleoside reverse transcriptase inhibitors (NRTIs)] and a ritonavir-boosted protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) remains the mainstay. In this article, we review the advantages, and drawbacks, of different non-thymidine NRTI backbones.
Waters
L J
LJ
Department of HIV/GU Medicine, Chelsea & Westminster Hospital, London, UK.
Nelson
M R
MR
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D004338:Drug Combinations; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D009705:Nucleosides / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D013936:Thymidine / Q000009:adverse effects / Q000031:analogs & derivatives*
D004338:Drug Combinations; D017320:HIV Protease Inhibitors; D009705:Nucleosides; D018894:Reverse Transcriptase Inhibitors; D013936:Thymidine