NRTIs Assignment Discussion Paper

NRTIs Assignment Discussion Paper

NRTIs are used in the initial treatment of ART naïve HIV-positive patients in combination with a separate class of drug. They work by inhibiting reverse transcription of the HIV reverse transcriptase by inducing the termination of the DNA chain (Wu et al, 2017). NRTIs have to be phosphorylated intracellularly to be active. However, NRTIs are associated with cross-resistance and long-term toxicity (Achhra & Boyd, 2013). Examples of NRTIs include zidovudine (Retrovir), lamivudine (Epivir), abacavir sulfate, didanosine, stavudine, and emtricitabine. NRTIs Assignment Discussion Paper

NNRTIs are antiviral drugs used in the treatment of HIV infection and AIDs. NNRTIs work by binding to the reverse transcriptase (an HIV enzyme) and therefore prevents the viral RNA to be converted to DNA because HIV utilizes reverse transcriptase in the conversion (Mahlich et al, 2016). Inhibiting of reverse transcriptase as well as reverse transcription averts replication of HIV. Side effects associated with NNRTIs include diarrhea, nausea, headache, dizziness, rash, fatigue, and nightmares (Mahlich et al, 2016).  Examples of NNRTIs are Intelence, Sustiva, Pifeltro, Edurant, and Viramune. NRTIs Assignment Discussion Paper


Integrase inhibitors are antiretroviral agents that work by inhibiting the action of enzyme integrase, a viral enzyme that integrates the viral genome in the DNA of the CD4 cells. Integration of the viral genome is a very important step in replication of retroviral, and hence inhibiting integration stops the multiplication of the HIV virus (Jacobson & Ogbuagu, 2018). Examples of integrase inhibitors include bictegravir, dolutegravir, elvitegravir, and raltegravir. Side effects associated with integrase inhibitors include diarrhea, nausea, headache, dizziness, rash, fatigue, muscle pain, and nightmares.


Achhra A & Boyd M. (2013). Antiretroviral regimens sparing agents from the nucleoside(tide) reverse transcriptase inhibitor class: a review of the recent literature. AIDS Research and Therapy. 10(33).

Jacobson K & Ogbuagu O. (2018). Integrase inhibitor-based regimens result in more rapid virologic suppression rates among treatment-naïve human immunodeficiency virus-infected patients compared to non-nucleoside and protease inhibitor-based regimens in a real-world clinical setting. Medicine (Baltimore). 97(43).

Mahlich J, Mona G, Kuhlmann A, Bogner J, Hans H & Stoll M. (2016). The choice between a ritonavir-boosted protease inhibitor- and a non-nucleoside reverse transcriptase inhibitor-based regimen for initiation of antiretroviral treatment – results from an observational study in Germany. J Pharm Policy Pract. 9(39).

Wu T, Juan Z, Geng M, Tang S, Zhang W & Shu J. (2017). Nucleoside reverse transcriptase inhibitors (NRTIs) induce proinflammatory cytokines in the CNS via Wnt5a signaling. Scientific RepoRts. 7(4117). NRTIs Assignment Discussion Paper

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