Etravirine is an oral diarylpyrimidine compound, a second-generation human immunodeficiency virus type 1 (HIV-1) non-
nucleoside reverse transcriptase inhibitor (NNRTI) with expanded
antiviral activity against NNRTI-resistant HIV-1, to be used in combination
therapy for treatment-experienced patients. Compared with first-generation NNRTIs,
etravirine has a high genetic barrier to resistance, and is better tolerated without the neuropsychiatric and hepatic side effects of
efavirenz and
nevirapine, respectively. Its safety profile is comparable to placebo with the exception of
rash, which has been mild and self-limited in the great majority of patients. In phase III clinical trials among treatment-experienced patients harboring NNRTI-resistant HIV-1,
etravirine in combination with an optimized background regimen (OBR) that included
ritonavir-boosted
darunavir demonstrated superior
antiviral activity than the control OBR. In addition, patients on the
etravirine arm had fewer
AIDS-defining conditions, hospitalizations, and lower mortality compared with the OBR control arm.