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HIV-1 entry inhibitors: classes, applications and factors affecting potency
Jasminka Sterjovski1, Melissa J Churchill, Steve L Wesselingh
1Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia.
New antiviral drugs, known as entry inhibitors, show promise for treating human immunodeficiency virus type-1 (HIV-1) infection. Understanding HIV-1 envelope protein evolution is key to developing effective entry inhibitors against resistant strains.
Area of Science:
- Virology
- Immunology
- Pharmacology
Background:
- Antiviral agents targeting human immunodeficiency virus type-1 (HIV-1) entry are crucial for treatment.
- Viral evolution and drug resistance pose significant challenges in HIV-1 therapy.
- The HIV-1 envelope protein (Env) variability complicates the development of entry inhibitors.
Purpose of the Study:
- To review current and emerging HIV-1 entry inhibitors.
- To examine factors influencing the potency of entry inhibitors.
- To highlight the importance of considering viral evolution in therapeutic design.
Main Methods:
- Review of preclinical and clinical data on HIV-1 entry inhibitors.
- Analysis of the relationship between Env evolution, co-receptor interactions, and fusogenicity.
- Examination of factors affecting inhibitor potency against HIV-1 variants.
Main Results:
- Entry inhibitors targeting attachment, co-receptor engagement, and fusion are promising.
- HIV-1 Env evolution can increase Env-CCR5 interactions, enhancing fusogenicity and reducing inhibitor sensitivity.
- Late-emerging HIV-1 variants present unique challenges for entry inhibitor efficacy.
Conclusions:
- Entry inhibitors represent a vital class of therapeutics for HIV-1 infection.
- Understanding Env variability and its impact on viral entry is critical for designing effective and durable treatments.
- Future HIV-1 therapeutic strategies must account for viral evolution and the properties of emergent strains.
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