Abstract
Integrase strand transfer inhibitors (INSTIs) have become the most important class of anti-HIV-1 drugs used as third element of the classic three-agent regimen. In addition, they have become pillars of simplified therapeutic schemes. They represent a fundamental resource which cannot be misused. In particular, the most worrisome risk is the occurrence of class resistance that could prevent physicians from employing this impressive weapon in the anti-HIV-1 armamentarium. A precise insight into mechanisms and pathway of resistance is necessary to use these drugs wisely. Pending the advent of new-generation INSTIs, differences among the ones currently available must be kept in mind, especially the greater barrier to resistance displayed by dolutegravir when compared with raltegravir and elvitegravir.
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