A Tolerability Review of Non-Nucleoside Reverse Transcriptase Inhibitors: Focus on Laboratory Measures of Clinical Relevance
Jeffrey T Kirchner*
Comprehensive Care Medicine for HIV, Lancaster General Hospital, Temple University School of Medicine, USA
- *Corresponding Author:
- Jeffrey T. Kirchner
Comprehensive Care Medicine for HIV
Lancaster General Hospital
554 North Duke Street
3rd floor, Lancaster, PA17602, USA
E-mail: [email protected]
Received Date: November 18, 2012; Accepted Date: November 26, 2012; Published Date: December 02, 2012
Citation: Kirchner JT (2012) A Tolerability Review of Non-Nucleoside Reverse Transcriptase Inhibitors: Focus on Laboratory Measures of Clinical Relevance. J Antivir Antiretrovir 4: 094-100. doi: 10.4172/jaa.1000052
Copyright: © 2012 Kirchner JT. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Current antiretroviral (ARV) therapies have greatly extended the life expectancy for many living with HIV infection. Given that ARV therapies must be taken chronically, long-term tolerability associated with these agents is of great importance. Clinical trials and experience have helped clarify short and long-term adverse event data. Among non-nucleoside reverse transcriptase inhibitors (NNRTIs), common laboratory markers of toxicity and tolerability include transaminase elevations and lipid alterations. Some of these issues appear to be a class-specific effect, whereas others appear to be more agent-specific. Selection of the appropriate NNRTI to use while limiting drug-related side effects is an important clinical objective.
Objective: To review clinically relevant data regarding long-term tolerability of NNRTIs.
Methods: A PubMed search was performed using the following keywords: NNRTI, non-nucleoside reverse transcriptase inhibitor, efavirenz, nevirapine, etravirine, rilpivirine and safety, tolerability or clinical. Papers published before 2007 were excluded; papers were included if they reported clinically relevant tolerability outcomes, enrolled more than 50 patients and were conducted for ≥ 48 weeks in HIV-infected patients. Results: Newer agents and formulations have significantly improved the tolerability issues associated with older ARVs and earlier treatment approaches.
Conclusions: Tolerability profile remains to be a distinguishing feature among the agents in this class, and is a key consideration when considering a first-line NNRTI-containing regimen that is individualized to the patient and can achieve long-term virologic suppression. This information may help guide treatment choices in clinical practice.