Raltegravir as antiretroviral therapy in HIV/AIDS

Introduction: HIV, a major cause of morbidity and mortality worldwide has been transformed by antiretroviral (ARV) therapy into a manageable condition. Drug resistance, tolerability and drug interactions remain major concerns when choosing ARV therapy. Raltegravir, the first integrase inhibitor in the armamentarium against HIV, has been shown to be efficacious in both treatment-naive and treatment-experienced patients when used in combination as part of nucleoside-reverse transcriptase inhibitor-containing regimens. Its key advantages include safety, tolerability and fewer drug interactions but it has some important limitations such as a lower barrier to resistance and a twice-daily dosing schedule. Its role in nucleoside-sparing regimens is under investigation. Areas covered: PubMed was searched for publications in English from 2004 to September 2013 using the terms 'raltegravir', 'integrase inhibitor' and 'MK-0518'. Relevant publications were reviewed and reference lists were examined for further publications. Conference abstracts from the Conference on Retroviruses and Opportunistic Infections, Interscience Conference on Antimicrobial Agents and Chemotherapy, and International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention for 2013 were also reviewed. Expert opinion: Raltegravir is an important agent for both naive and experienced HIV patients. Its key features include its tolerability, efficacy and lack of significant drug interactions.