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Universal antiretroviral regimens: thinking beyond one-pill-once-a-day.
Jeffrey M Jacobson1, Charles W Flexner
1aDepartments of Medicine and Neuroscience, Center for Translational AIDS Research, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania bDivisions of Clinical Pharmacology and Infectious Diseases, School of Medicine and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Current Opinion in HIV and AIDS
|April 4, 2017
Summary
Long-acting antiretroviral therapies, including injectables and implants, show promise for HIV-1 treatment. These novel strategies offer alternatives for individuals struggling with daily oral medications, improving adherence and treatment success.
Area of Science:
- Pharmaceutical nanotechnology
- Virology
- Immunology
Background:
- Poor adherence to oral antiretroviral therapy (ART) hinders HIV-1 treatment success.
- Long-acting (LA) antiretroviral strategies are in development to address adherence challenges.
Purpose of the Study:
- Review LA antiretroviral strategies in clinical development.
- Evaluate their potential for HIV-1 treatment in non-adherent populations.
Main Methods:
- Review of clinical development data for LA antiretroviral compounds and monoclonal antibodies.
- Assessment of safety, tolerability, and efficacy in early-stage trials.
Main Results:
- Two injectable LA antiretrovirals (cabotegravir, rilpivirine) show safety and prolonged activity.
- A novel oral/implant LA nucleoside reverse transcriptase inhibitor (EFdA) is in development.
- Monoclonal antibodies demonstrate antiviral activity but face resistance challenges.
Conclusions:
- LA antiretroviral compounds and monoclonal antibodies show potent anti-HIV activity.
- Advanced clinical trials are underway for treatment and prevention.
- Managing toxicities, drug levels, and resistance are key considerations.