Which medications in the drug class Antiretroviral agent, nucleoside reverse-transcriptase inhibitor are used in the treatment of HIV Infection and AIDS?

Updated: Jul 01, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Antiretroviral agent, nucleoside reverse-transcriptase inhibitor

NRTIs agents inhibit viral replication by inhibiting viral RNA–dependent DNA polymerase.

Abacavir (Ziagen)

This NRTI interferes with HIV viral RNA–dependent DNA polymerase and inhibits viral replication. Guidelines from the Department of Health and Human Services Panel on Clinical Practices for Treatment of HIV Infection recommends screening for HLA-B*5701 before starting patients on a regimen that contains abacavir, to reduce the risk of hypersensitivity reaction.

Didanosine (Videx, Videx EC)

Didanosine interferes with HIV viral RNA–dependent DNA polymerase and inhibits viral replication.

Emtricitabine (Emtriva)

This agent is a synthetic nucleoside cytosine analog classified as an NRTI. It competes with deoxycytidine-5'-triphosphate and incorporates into viral DNA, causing chain termination.

Lamivudine (Epivir)

Lamivudine is a thymidine analog that inhibits viral replication.

Stavudine (Zerit, Zerit XR)

Stavudine competes with deoxycytidine-5'-triphosphate and incorporates into viral DNA, causing chain termination.

Tenofovir disoproxil fumarate (Viread)

This agent inhibits the activity of HIV reverse transcriptase by competing with the natural substrate deoxyadenosine 5'-triphosphate and, after incorporation into DNA, by DNA chain termination. It is administered as the prodrug bis-isopropoxycarbonyloxymethyl ester derivative of tenofovir, which is converted, through various enzymatic processes, to tenofovir, a nucleotide analog of adenosine 5'-monophosphate. Bioavailability is enhanced by a high-fat meal. Prolonged intracellular distribution allows for once-daily dosing.

This drug has shown substantial efficacy and safety in PReP trials with IV drug users and heterosexually active adults. CDC guidelines recommend tenofovir alone as an alternative regimen to emtricitabine/tenofovir for these populations, but not for MSM, among whom its efficacy has not been studied.

Zidovudine (Retrovir)

Zidovudine is a thymidine analog that inhibits viral replication.


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