Efavirenz--still first-line king?
BACKGROUND
Efavirenz is a potent, safe and tolerable non-nucleoside reverse transcriptase inhibitor (NNRTI) recommended as initial therapy. Recently, several new antiretroviral drugs, including second generation NNRTIs, protease-inhibitors, an integrase-inhibitor and a CCR5 inhibitor, have become or will be shortly available.


OBJECTIVE
This article will review relevant efficacy and safety data of efavirenz compared to these novel agents or certain common alternate drugs currently used as initial therapy in treatment-naive patients.


METHODS
Published articles and conference presentations pertaining to efavirenz and/or the newer antiretroviral agents were evaluated.


CONCLUSIONS
Efavirenz will continue to be preferred initial therapy for now. If longer-term studies of integrase inhibitors and second-generation NNRTIs confirm initial findings, they will eventually supplant efavirenz as preferred first-line agents.
Best
Brookie M
BM
University of California, Division of Pharmacology and Drug Discovery, San Diego, La Jolla, CA 92093-0719, USA. brookie@ucsd.edu
Goicoechea
Miguel
M
D000480:Alkynes; D000818:Animals; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D048588:Benzoxazines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003521:Cyclopropanes; D004347:Drug Interactions; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; C098320:efavirenz