{"id":7864,"date":"2025-01-01T12:00:19","date_gmt":"2025-01-01T12:00:19","guid":{"rendered":"http:\/\/i-base.info\/guides\/?page_id=7864"},"modified":"2025-01-20T14:50:07","modified_gmt":"2025-01-20T14:50:07","slug":"cross-resistance","status":"publish","type":"page","link":"https:\/\/i-base.info\/guides\/changing\/cross-resistance","title":{"rendered":"Cross-resistance by drug class"},"content":{"rendered":"

\"\"There are many types (or classes) of drugs. Each one works at different stages of the HIV life cycle.<\/strong><\/p>\n

NRTIs<\/strong><\/p>\n

Cross-resistance between NRTIs is complex. Some drugs are active even with some resistance.<\/p>\n

NNRTIs<\/strong><\/p>\n

There is strong cross-resistance between early NNRTIs such as nevirapine and efavirenz.<\/p>\n

Second-generation NNRTIs like etravirine, rilpvirine and doravirine can sometimes overcome early drug resistance.<\/p>\n

This needs advice from a resistance specialist.<\/p>\n

Protease inhibitors (PIs)<\/strong><\/p>\n

There is strong cross-resistance between some PIs.<\/p>\n

Some PIs, including darunavir\/r and tipranavir\/r, can work against early PI resistance.<\/p>\n

Darunavir\/r is sometimes used twice-daily tto overcome drug resistance.<\/p>\n

Integrase inhibitors<\/strong><\/p>\n

As a new class, integrase inhibitors work if you have resistance to other drug classes. But they can also have cross-resistance within the class.<\/p>\n

Resistance to raltegravir<\/a> or elvitegravir<\/a> can sometimes be overcome by using a higher dose of dolutegravir<\/a> (50 mg twice a day).<\/p>\n

Dolutegravir<\/a> and bictegravir<\/a> have stronger barrier to drug resistance than other integrase inhibitors.<\/p>\n

Entry inhibitors<\/strong><\/p>\n

Several different type of types are entry inhibitors. Drugs that work in differenet ways ddo not have cross resistance. These include:<\/p>\n