*9.2.1. Etravirine*

Etravirine (ETR, Intelence®) is a drug that has shown efficacy, safety and good tolerability in HIV-1 patients [157]. One of the great advantages of etravirine is as a replacement for other NNRTIs to which the HIV-1 virus is resistant, mainly due to the presence of the K103N and Y181C mutation in the case of efavirenz and nevirapine, respectively. The FDA approved the drug in 2008 for use in patients with multiple drug resistance. However, the drug is a substrate and an inhibitor of different CYP3A4 enzymes, which in turn are contraindicated with antimicrobial and anticonvulsant drugs metabolized by the CYP450 system. In patients receiving HAART and who have alterations in lipid metabolism, the switch to a therapy containing etravirine has shown satisfactory results and the reversal of dyslipidemia [157-160].

#### *9.2.2. Rilpivirine*

Rilpivirine (RPV, Edurant®) a NNRTIs class drug is more potent than diarylpyrimidine (DAPY), its adverse effects are considerably reduced compared to older NNRTIs such as efavirenz. After clinical trials, rilpivirine was approved by the FDA in 2011, and its use is combined with emtricitabine and tenofovir. Rilpivirine produces few changes in serum TC, LDL, HDL and TG in HIV-1 patients. In comparison to the treatment with efavirenz, this drug promotes an increase in lipids and in the TC:HDL ratio, which is characterized by an increased risk of cardiovascular diseases in these patients [161, 162].
