Reverse transcriptase inhibitors side effects

Nelfinavir is a nonpeptidic, rationally designed HIV protease inhibitor. Nelfinavir has demonstrated efficacy in both monotherapy and in combination with the reverse transcriptase inhibitors stavudine (d4T) or zivudine + 3TC. The major side effect is mild to moderate diarrhea. 

ISONIAZID ANTIVIRALS-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS t adverse effects with didanosine and possibly stavudine Additive side-effects Monitor closely for the development of peripheral neuropathy, but no dose adjustment is required... 

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS RIBAVIRIN 1. t side-effects, risk of lactic acidosis, peripheral neuropathy, pancreatitis, hepatic decompensation, mitochondrial toxicity and anaemia with didanosine and stavudine 2.1 efficacy of lamivudine 1. Additive side-effects t intracellular activation of didanosine and stavudine 2. J intracellular activation of lamivudine 1. Not recommended. Use with extreme caution monitor lactate, LFTs and amylase closely. Stop co-administration if peripheral neuropathy occurs. Stavudine and didanosine carry a higher risk 2. Monitor HIV RNA levels if they T, review treatment combination... 

Nevirapine (NVP), a nonnucleoside reverse transcriptase inhibitor, is widely used for the treatment of human immunodeficiency virus (HIV) infections. It is the main option for the first-line treatment of HIV-1, together with two nucleoside reverse transcriptase inhibitors, in countries with limited resources. NVP is associated with two serious clinically restrictive side effects skin reactions and hepatotoxicity. Severe, life threatening, and in some cases fatal hepatotoxicity, including fulminant and cholestatic hepatitis, hepatic necrosis, and hepatic failure, has been reported in HIV-infected patients taking NVP (DHHS Panel on Antiretroviral Guidelines for Adults and Adolescents 2008). For this reason, NVP is given a black box warning for hepatotoxicity, and concern has been raised over NVP-based treatment. 

Indinavir (Crixivan) is a potent inhibitor of HIV reverse transcriptase. It produces the side effects common to aU protease inhibitors and also may produce nephrolithiasis, urolithiasis, and possibly renal insufficiency or renal failure. This problem occurs more fre-... 

B. Ritonavir is a potent inhibitor of CYP3A4, the enzyme that rapidly inactivates lopinavir. This combination includes a low dose of ritonavir that is not likely to cause serious side effects but instead inhibits lopinavir metabolism. Ritonavir and lopinavir are HIV protease inhibitors and do not affect reverse transcriptase. Lopinavir is almost completely eliminated by metabolism to inactive metabolites little is eliminated unchanged by the kidney. Lopinavir is not known to inhibit the ability of HIV to mutate. Lopinavir inhibits the enzyme HIV protease, not a structural protein. 

While over 33 million people are living with HIV/AIDS, the impact of HIV therapies has been shown by a nationwide decline in AIDS-related deaths. The vast majority of anti-HIV therapeutic agents have been limited to reverse transcriptase and protease inhibitors.5,6 However, the development of resistance to these inhibitors7 and the toxic side effects associated with these compounds8 indicate a major need for further discovery and development of alternative strategies such as those targeting other stages... 

Reverse transcriptase is a key enzyme which plays an essential and multifunctional role in the replication of HIV-1 and thus constitutes an attractive target for the development of new drugs that could be used in AIDS therapy. A combination of reverse transcriptase and protease inhibitors is an effective approach to the treatment of AIDS [32], However, side effects and the clinical emergence of resistant mutants suggests an increasing need for novel antiviral drugs. 

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