Pharmacotherapy of HIV: Focus on Etravirine

Etravirine (ETR) is a novel non-nucleoside reverse transcriptase inhibitor (NNRTI) designed for binding to HIV reverse transcriptase in spite of most of the mutations which normally confer resistance to the other drugs of the same class. Evidences from clinical trials and post-marketing drug use provide guidance for the use of the drug in NNRTI-experienced patients. However, despite the raised genetic barrier, progressive loss of ETR susceptibility is seen as resistance mutations accumulate and a certain degree of cross-resistance with first-generation NNRTI occurs however. Moreover, most of the experiences in using ETR come from the setting of co-administration with darunavir/ritonavir, whilst little is known about its use with other companions. A full knowledge of all available evidences on the drug is therefore needed, in order to optimize the use of ETR in clinical practice.