Recent efficacy data on integrase inhibitors has been strong, and this class of drugs is quickly emerging as a preferred first-choice for treatment. Integrase inhibitors are better tolerated over time. For example, in a long-term study that compared the integrase inhibitor raltegravir (Isentress) to efavirenz, over time raltegravir proved superior because of its better side-effect profile.
However, there is a concern with integrase inhibitors, as the price of failing with these drugs might be virological resistance. It's clear that if patients are failing on an integrase inhibitor, they should switch medication immediately to avoid building up additional virological mutations. Drug resistance is a real problem for some integrase inhibitors, but one, dolutegravir (Tivicay, DTG), seems less prone to resistance than others.