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The nonnucleoside reverse transcriptase inhibitor (NNRTI) efavirenz is an anchor drug in one of the four initial treatment regimens preferred by the U.S. Department of Health and Human Services and is available as part of a once-daily single-pill treatment. However, this drug is associated with central nervous system (CNS) adverse events that are sometimes severe, and it also causes lipid abnormalities. Etravirine, a newer NNTRI, has been suggested as an alternative to efavirenz for patients with virologic suppression. Two research groups (both with support from Tibotec, the manufacturer of etravirine) recently explored the implications of switching from efavirenz to etravirine.
Nguyen and colleagues conducted a randomized crossover study in…