Abacavir

Abacavir is a nucleoside reverse-transcriptase inhibitor used with other antiretroviral medicines to treat HIV infection. It is distinctive for a potentially life-threatening hypersensitivity reaction strongly associated with the HLA-B*57:01 genetic variant.

Nucleoside reverse-transcriptase inhibitors: Antiretroviral drugs that mimic nucleosides and inhibit HIV reverse transcriptase after activation inside cells. Abacavir belongs to this drug class and shares its chain-terminating mechanism.
Antiretroviral therapy: Combination treatment that suppresses HIV using medicines targeting different stages of viral replication. Abacavir is used as one component of combination HIV treatment, not as monotherapy.
Abacavir hypersensitivity reaction: A potentially life-threatening multisystem reaction to abacavir, strongly associated with HLA-B*57:01. This defining safety risk requires screening and permanent avoidance after a suspected reaction.
Tenofovir disoproxil fumarate: A nucleotide reverse-transcriptase inhibitor used to treat HIV and hepatitis B infection. It is an alternative backbone drug with different renal, bone, and cardiovascular considerations.
Reverse transcriptase: An enzyme that copies RNA into DNA, enabling retroviruses such as HIV to integrate genetic material into host cells. Abacavir’s active metabolite inhibits this enzyme during viral DNA synthesis.
Abacavir/lamivudine: A fixed-dose combination of two nucleoside reverse-transcriptase inhibitors used in HIV treatment. This common tablet pairs abacavir with lamivudine, another inhibitor of reverse transcriptase.
HLA-B*57:01: A human leukocyte antigen allele strongly associated with immune-mediated abacavir hypersensitivity. The allele provides a genetic marker for the reaction that transformed abacavir prescribing.
Zidovudine: A thymidine-analogue nucleoside reverse-transcriptase inhibitor used in HIV treatment and prevention. Unlike abacavir, zidovudine is particularly associated with bone-marrow suppression and anemia.
Carbovir triphosphate: The intracellular active metabolite of abacavir that competes with natural nucleotides during HIV DNA synthesis. This metabolite, rather than the administered drug itself, directly inhibits reverse transcriptase.
Dolutegravir/abacavir/lamivudine: A fixed-dose HIV treatment combining the integrase inhibitor dolutegravir with abacavir and lamivudine. This regimen shows how abacavir can be combined with drugs from another antiretroviral class.

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StavudineCompared with: Abacavir offered an alternative backbone drug without stavudine’s characteristic lipoatrophy risk.