Anti-Retroviral Drugs for HIV: Old and New

Review Article

Austin J HIV/AIDS Res. 2016; 3(2): 1026.

Anti-Retroviral Drugs for HIV: Old and New

Vaidya KA, Kadam AV and Nema V*

National AIDS Research Institute, 73 G Block, M.I.D.C Bhosari, India

*Corresponding author: Vijay Nema, National AIDS Research Institute, 73 G Block, M.I.D.C Bhosari, India

Received: April 25, 2016; Accepted: June 06, 2016; Published: June 08, 2016

Abstract

Treatment of HIV started as monotherapy initially, and then multiple drugs in regimens were given where patients had to consume 11-16 tablets per day. Now the mainstay of the treatment is a single fixed dose combination of Tenofovir, Lamivudine and Efavirenz per day or Zidovudine, Lamivudine and Nevirapine twice daily. Toxicity, resistance and adherence still remaina crucial issue. We need long acting depot preparations which would be efficacious for prevention, treatment and have fewer side effects. To implement test and treat policy promoted by WHO, regular supply of cost effective antiretroviral drugs and newer drugs which would get approved remains a challenge for developing countries. Hence we tried reviewing upcoming new molecules which showed potential to be good drugs in various phases of clinical trial.

Keywords: Newer Anti retroviral drugs; HIV; US FDA approved ARV drugs

Introduction

HIV (Human Immunodeficiency Virus) is a retrovirus that gradually attacks the immune system, which protects human body against illness. HIV infected person becomes a easy target for opportunistic infections and diseases. This virus multiplies in T-helper cell (CD4) and gradually depletes them. The two main types are HIV-1 and HIV-2. HIV-1 is the most common type found worldwide; However HIV-2 is found mainly in Western Africa, with some cases in India and Europe [1]. Currently, around 15 molecules are being used in different treatments regimens to treat HIV infections, however, issues like treatment failure due to drug resistance and toxicity remain crucial issues. The purpose of this review is to brief about newer antiretroviral drugs (Pharmacokinetics and pharmacodynamics) for HIV, which are recently approved and/ or newer promising drugs in pipeline i.e. phase 2 and phase 3 trials. Using newer antiretroviral drugs as keyword in PubMed, DAIDS, CDC website, AIDS info FDA websites were searched thoroughly for recent updates.

Basic Facts about HIV

HIV infected person would develop AIDS in 10 to 15 years which is last clinical stage. HIV mainly found in blood, semen, vaginal and anal fluids and breast milk. However, it cannot be transmitted through sweat, saliva or urine. Currently, there is no cure for HIV but with early diagnosis and effective Antiretroviral (ARV) treatment, people with HIV can live a long and normal, healthy life. Therefore, it is important to take correct treatment regularly. The drugs currently available for HIV blocks the replication by interfering at various stages of the life cycle. These drugs have their own toxicities and many have reported development of resistance. We have left with very few options in our arm our against HIV.

HIV Virus Life Cycle and Antiviral Drug Targets (Figure 1)