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Treatment optimization: an outline for future success.

Charles Flexner¹, Ben Plumley, David H Brown Ripin

¹aJohns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland bPangaea Global AIDS Foundation, Oakland, California cClinton Health Access Initiative, Boston, Massachusetts, USA.

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Summary

Global HIV treatment optimization focuses on developing more effective, accessible, and affordable therapies. Key recommendations include efficient drug chemistry, dose reduction, and addressing comorbidities for lifelong treatment access.

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Area of Science:

Infectious Diseases
Pharmacology
Public Health

Background:

Current HIV treatment strategies aim for long-term efficacy and patient adherence.
Global efforts are underway to enhance the accessibility and affordability of antiretroviral therapies.

Purpose of the Study:

To provide a comprehensive overview of current activities in optimizing global HIV treatment.
To outline goals and approaches for improving HIV therapies and their accessibility.

Main Methods:

Convened experts from diverse sectors (academia, industry, government, community) at two conferences (CADO).
Developed a global HIV-treatment research agenda focusing on therapeutic advancements and access strategies.

Main Results:

Recommended more efficient process chemistry for antiretroviral drugs.
Explored antiretroviral dose reduction as an optimization strategy.
Highlighted the importance of managing concurrent infections (e.g., tuberculosis) and comorbidities (e.g., aging-related diseases).
Identified the need for a highly effective, affordable, non-toxic, once-daily fixed-dose combination regimen for first-line treatment.

Conclusions:

HIV treatment optimization enhances long-term efficacy, adherence, tolerability, safety, convenience, and affordability of combination antiretroviral therapy (ART).
The ultimate goal is to ensure access to well-tolerated, effective lifelong HIV treatment for all individuals in need.