Current status and prospects of HIV treatment

•With no available cure, treatment of HIV infection requires life-long therapy.•A combination of three drugs is the current standard for chronic HIV therapy.•Multiple single-tablet 3-drug combination regimens are available.•Long-term success of HIV therapy requires both efficacy and safety/tolerabil...

Full description

Saved in:

Bibliographic Details
Published in:	Current opinion in virology 2016-06, Vol.18, p.50-56
Main Authors:	Cihlar, Tomas, Fordyce, Marshall
Format:	Article
Language:	eng
Subjects:	Anti-HIV Agents - administration & dosage Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Antibodies, Neutralizing - therapeutic use Antiretroviral Therapy, Highly Active Drug Resistance, Viral Drug Therapy, Combination HIV Infections - drug therapy HIV Infections - therapy HIV Infections - virology HIV-1 - drug effects Humans
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	•With no available cure, treatment of HIV infection requires life-long therapy.•A combination of three drugs is the current standard for chronic HIV therapy.•Multiple single-tablet 3-drug combination regimens are available.•Long-term success of HIV therapy requires both efficacy and safety/tolerability.•Novel drug classes are in clinical development for patients with drug resistance. Current antiviral treatments can reduce HIV-associated morbidity, prolong survival, and prevent HIV transmission. Combination antiretroviral therapy (cART) containing preferably three active drugs from two or more classes is required for durable virologic suppression. Regimen selection is based on virologic efficacy, potential for adverse effects, pill burden and dosing frequency, drug–drug interaction potential, resistance test results, comorbid conditions, social status, and cost. With prolonged virologic suppression, improved clinical outcomes, and longer survival, patients will be exposed to antiretroviral agents for decades. Therefore, maximizing the safety and tolerability of cART is a high priority. Emergence of resistance and/or lack of tolerability in individual patients require availability of a range of treatment options. Development of new drugs is focused on improving safety (e.g. tenofovir alafenamide) and/or resistance profile (e.g. doravirine) within the existing drug classes, combination therapies with improved adherence (e.g. single-tablet regimens), novel mechanisms of action (e.g. attachment inhibitors, maturation inhibitors, broadly neutralizing antibodies), and treatment simplification with infrequent dosing (e.g. long-acting injectables). In parallel with cART innovations, research and development efforts focused on agents that target persistent HIV reservoirs may lead to prolonged drug-free remission and HIV cure.
ISSN:	1879-6257 1879-6265