Integrase strand transfer inhibitors (INSTIs) like dolutegravir act at which step of the HIV replication cycle?

• A Inhibiting HIV integrase enzyme, preventing insertion of reverse-transcribed HIV cDNA into host chromosomal DNA ✓
• B Binding to CCR5/CXCR4 co-receptors, preventing viral entry
• C Blocking HIV protease from cleaving Gag and Gag-Pol polyproteins
• D Blocking reverse transcriptase from synthesizing DNA from the viral RNA genome

Explanation

INSTIs (raltegravir, elvitegravir, dolutegravir, bictegravir) inhibit HIV integrase, specifically the strand transfer step where the viral cDNA (made by reverse transcriptase) is inserted into host chromosomal DNA. Without integration, the virus cannot establish a permanent reservoir or produce new virions via host transcription machinery. Dolutegravir has a high barrier to resistance and favorable tolerability profile. CCR5 antagonists (maraviroc) block co-receptor binding; protease inhibitors block viral maturation; NRTIs/NNRTIs block reverse transcription.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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