The era of the integrase strand transfer inhibitors (INSTIs) for the treatment of human immunodeficiency virus (HIV) infection began with raltegravir in 2007. Since that time, several other INSTIs have been introduced including elvitegravir, dolutegravir, and, most recently, bictegravir, that have shown great utility as part of antiretroviral regimens in both treatment-naive and treatment-experienced patients. At present, antiretroviral guidelines fully endorse the INSTI class as part of all first-line treatment regimens. After 10 years of experience with INSTIs, newer agents are on the horizon such as cabotegravir and MK-2048 for potential use as either HIV pre-exposure prophylaxis or maintenance therapy. This review provides a brief overview of the INSTI class including agents currently available and those still in development, reviews available data from both completed and ongoing clinical trials, and outlines simplification strategies using INSTIs.
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View Article and Find Full Text PDFArticle Synopsis
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- - Among 114 cases reviewed from October 2018 to January 2024, 90% had available resistance sequences, with significant findings showing that many had prior ART exposure and a notable percentage of those developed INSTI-DRMs, primarily from low/middle-income countries.
- - The research recommended treatment adjustments, emphasizing the need for enhanced access to effective therapies and the importance of addressing drug resistance in this patient population, particularly those with extensive treatment histories.
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