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Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
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AIDS is caused by a RNA containing retrovirus called human immunodeficiency virus, or HIV. The “retro” part of retrovirus isn’t referring to its style, but refers to it needing to use an enzyme called reverse transcriptase to transcribe a piece of “proviral” DNA from its RNA.
As the name suggests, reverse transcriptase inhibitors go and inhibit this enzyme, and prevent HIV replication.
They can either be nucleoside reverse transcriptase inhibitors, or NRTIs, which resemble nucleosides, which are the building blocks of nucleic acids like DNA and RNA; or non-nucleoside reverse transcriptase inhibitors, or NNRTIs, which dont resemble nucleosides.
These include macrophages, dendritic cells, and especially CD4+ T-helper cells. Normally, the CD4 molecule helps these cells attach to and communicate with other immune cells, which is particularly important when the cells are launching attacks against foreign pathogens.
HIV attaches to the CD4 molecule via a protein called gp120 found on its envelope. Now, inside its envelope, HIV contains a nucleocapsid which is a capsule containing a single-stranded RNA and some viral enzymes, like reverse transcriptase and integrase.
Once it’s inside the CD4+ cell, reverse transcriptase gets to work immediately. It uses the single stranded viral RNA as a template, and uses the nucleotides present in the cytoplasm of the CD4+ cell to transcribe a complementary double-stranded “proviral” DNA.
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are a type of antiviral medication used to treat HIV infection. They work by inhibiting the HIV's reverse transcriptase enzyme, thus preventing the multiplication of the virus.
Some NNRTIs such as efavirenz and delavirdine are teratogenic. Non-teratogenic NNRTIs include nevirapine and etravirine. Common side effects of NNRTIs include hypersensitivity reactions, dizziness, hallucinations, vivid dreams, and in some cases, there may be toxic epidermal necrolysis and Stevens-Johnson syndrome.
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