title: New therapeutic landscape of NNRTIs for treatment of HIV: a look at recent data.
abstract: BACKGROUND
  A key objective with highly active antiretroviral therapy for the treatment of HIV infection has been the optimization of antiretroviral drug combinations for individual patients.
  
  
  METHODS
  Overall, non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens (in combination with two nucleoside reverse transcriptase inhibitors (NRTIs)) have become mainstays for initial ARV regimens. Early NNRTIs, efavirenz and nevirapine, are similarly efficacious, but differ according to their toxicity profiles. Newer NNRTIs, rilpivirine and etravirine are also efficacious. Etravirine was designed to overcome common first-line NNRTI resistance mutations, and serves as a second line agent.
  
  
  CONCLUSIONS
  As a class, NNRTIs are key components of ARV regimens. Currently, there are 3 NNRTIs that may be used in first-line regimens, and one in second-line regimens. ARV regimen optimization depends on matching individual drug efficacy, safety, resistance, and toxicity profiles to particular patients. Once-daily dosing options are essential to treatment simplification strategies, which have been shown to enhance regimen compliance and durabiltiy. These are especially important due to the low genetic barrier to resistance generally associated with NNRTIs. As newer drugs are introduced, especially as part of once-daily, single-tablet regimens, this will expand the number of convenient and efficacious treatment options available.
authors.affiliation: University of Miami Miller School of Medicine, Division of Infectious Diseases, Department of Medicine, Room 857 Clinical Research Bldg, 1120 NW 14th Street, Miami, FL 33136, USA. djayawee@med.miami.edu
authors.forename: Dushyantha
authors.initials: D
authors.lastname: Jayaweera
authors.forename: Paula
authors.initials: P
authors.lastname: Dilanchian
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000639:trends; D002986:Clinical Trials as Topic; D024882:Drug Resistance, Viral; D006678:HIV / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D009570:Nitriles / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D011724:Pyridazines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000068696:Rilpivirine
chemical_list: D009570:Nitriles; D011724:Pyridazines; D011743:Pyrimidines; D018894:Reverse Transcriptase Inhibitors; C451734:etravirine; D000068696:Rilpivirine