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lüll Raltegravir: the first HIV type 1 integrase inhibitor Hicks C; Gulick RMClin Infect Dis 2009[Apr]; 48 (7): 931-9Raltegravir is the first approved human immunodeficiency virus type 1 (HIV-1) integrase inhibitor; it targets the strand transfer step of HIV-1 integration. Clinical trials have demonstrated that raltegravir-containing regimens have potent antiretroviral activity and are well tolerated in HIV-1-infected individuals. In antiretroviral treatment-experienced persons with drug-resistant HIV infection, raltegravir-containing treatment with an optimized background regimen was superior to an optimized background regimen alone. In treatment-naive persons, raltegravir was not inferior to efavirenz when the drugs were administered with tenofovir and lamivudine or emtricitabine. Raltegravir is metabolized by glucuronidation, not hepatically; thus, the potential for drug-drug interactions is decreased. Drug resistance, conferred by substitutions in the gene coding for the HIV-1 integrase enzyme, develops relatively frequently after virologic failure. As an antiretroviral drug with a novel mechanism of action, raltegravir is an important advancement in HIV-1 treatment options.|Anti-HIV Agents/metabolism/*pharmacology/*therapeutic use[MESH]|Clinical Trials as Topic[MESH]|Drug Resistance, Viral[MESH]|HIV Infections/*drug therapy[MESH]|HIV-1/*drug effects[MESH]|Humans[MESH]|Integrase Inhibitors/metabolism/pharmacology/therapeutic use[MESH]|Pyrrolidinones/metabolism/*pharmacology/*therapeutic use[MESH]|Raltegravir Potassium[MESH] |