Portal:Viruses/Selected intervention/7

Nevirapine (also Viramune) is an antiretroviral drug used in the treatment of HIV/AIDS caused by HIV-1. It was the first non-nucleoside reverse transcriptase inhibitor to be licensed, which occurred in 1996. Like nucleoside inhibitors, nevirapine inhibits HIV's reverse transcriptase enzyme, which copies the viral RNA into DNA and is essential for its replication. Unlike nucleoside inhibitors, it binds not in the enzyme's active site but in a nearby hydrophobic pocket, causing a conformational change in the enzyme that prevents it from functioning. Mutations in the pocket generate resistance to nevirapine, which develops rapidly unless viral replication is completely suppressed. The drug is therefore only used together with other anti-HIV drugs in combination therapy. The HIV-2 reverse transcriptase has a different pocket structure, rendering it inherently resistant to nevirapine and other first-generation NNRTIs. A single dose of nevirapine is a cost-effective way to reduce mother-to-child transmission of HIV, and has been recommended by the World Health Organization for use in resource-poor settings. Other protocols are recommended in the United States. Rash is the most common adverse event associated with the drug.