Simplification of antiretroviral therapy with etravirine

Etravirine is the first representative of a new generation of nonnucleoside reverse transcriptase inhibitors and demonstrates potent antiviral activity against HIV strains resistant to other available nonnucleoside reverse transcriptase inhibitors. The drug demonstrates efficacy when added to an optimized background regimen in patients who experience virologic failure with multiple drug classes including nonnucleoside reverse transcriptase inhibitors. Although the pill burden (four pills) is currently higher than that for nevirapine and efavirenz, etravirine can be taken once daily and may also be dispersed in water. It appears to be a safe and tolerable option. Due to its lack of significant interactions, its efficacy, and tolerability, it can be considered a suitable option for antiretroviral therapy, even in patients with prior exposure to nonnucleoside reverse transcriptase inhibitors. Long-term trials are necessary to confirm the role of etravirine in simplification strategies, but preliminary clinical data is reassuring.