van Leth F, Lange J M
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Inwen- dige Geneeskunde, onderafd. Infectieziekten, Tropische Geneeskunde en Aids, Center for Poverty-related Communicable Diseases, Amsterdam.
Ned Tijdschr Geneeskd. 2006 Aug 5;150(31):1719-22.
The non-nucleoside reverse transcriptase inhibitors (NNRTIs) are an important group ofantiretroviral drugs in the treatment of a chronic HIV-I infection. The risk of viral resistance to NNRTIs is strongly diminished when they are used as part of a highly active antiretroviral combination therapy (HAART). Randomised trials have shown that nevirapine and efavirenz have a comparable antiretroviral efficacy. While rash and hepatotoxicity are associated with the use of nevirapine, the use of efavirenz is associated with neuropsychiatric abnormalities. The increase in HDL-cholesterol, which may be associated with a lower risk of cardiovascular disease, is greater with nevirapine than with efavirenz. The choice between the two drugs can be tailored to the needs of the patient. The rapid selection ofNNRTI-resistant HIV-I strains during the sub-optimal use of nevirapine and efavirenz demands the development of new NNRTIs.
非核苷类逆转录酶抑制剂（NNRTIs）是治疗慢性HIV-1感染的一类重要抗逆转录病毒药物。当它们作为高效抗逆转录病毒联合疗法（HAART）的一部分使用时，病毒对NNRTIs产生耐药性的风险会大大降低。随机试验表明，奈韦拉平和依非韦伦具有相当的抗逆转录病毒疗效。虽然皮疹和肝毒性与奈韦拉平的使用有关，但依非韦伦的使用与神经精神异常有关。奈韦拉平使高密度脂蛋白胆固醇升高的幅度大于依非韦伦，这可能与较低的心血管疾病风险有关。这两种药物的选择可以根据患者的需求进行调整。在奈韦拉平和依非韦伦使用不当时，NNRTI耐药HIV-1毒株会迅速出现，这就需要开发新的NNRTIs。
