Is there a role for non-nucleoside reverse transcriptase inhibitors in the treatment of HIV infection?

Because the efficacy of currently approved antiretroviral agents used as prolonged monotherapy is limited, there is an urgent need for alternative agents for the treatment of HIV infection. We review the development of a diverse group of new compounds, the non-nucleoside reverse transcriptase inhibitors (NNRTIs), which are potent and specific inhibitors of HIV replication. Early clinical experience with the NNRTIs has demonstrated antiviral activity and a high therapeutic index, but some patients rapidly develop viral strains resistant to these drugs. The contributions of NNRTI studies to the basic science of HIV pathogenesis and the potential clinical role of these compounds, particularly in combination antiretroviral regimens, are discussed.