The Promise of Long-Acting Antiretroviral Therapies

From Need to Manufacture

Howard Eliot Gendelman, JoEllyn M McMillan, Aditya N. Bade, Benson J Edagwa, Bhavesh D. Kevadiya

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Antiretroviral therapy has transformed human immunodeficiency virus infections from certain death to a manageable chronic disease. Achieving strict adherence to drug regimens that limit toxicities and viral resistance is an achievable goal. Success is defined by halting viral transmission and by continuous viral restriction. A step towards improving treatment outcomes is in long-acting antiretrovirals. While early results remain encouraging there remain opportunities for improvement. These rest, in part, on the required large drug dosing volumes, local injection-site reactions, and frequency of injections. Thus, implantable devices and long-acting parenteral prodrugs have emerged which may provide more effective clinical outcomes. The recent successes in transforming native antiretrovirals into lipophilic and hydrophobic prodrugs stabilized into biocompatible surfactants can positively affect both. Formulating antiretroviral prodrugs demonstrates improvements in cell and tissue targeting, in drug-dosing intervals, and in the administered volumes of nanosuspensions. As such, the newer formulations also hold the potential to suppress viral loads beyond more conventional therapies with the ultimate goal of HIV-1 elimination when combined with other modalities.

Original languageEnglish (US)
Pages (from-to)593-606
Number of pages14
JournalTrends in Microbiology
Volume27
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Prodrugs
Injections
Virus Diseases
Drug Delivery Systems
Viral Load
Surface-Active Agents
Pharmaceutical Preparations
HIV-1
Chronic Disease
Therapeutics
HIV
Equipment and Supplies

Keywords

  • good manufacturing practices
  • human immunodeficiency virus type one (HIV-1)
  • implantable devices
  • long-acting slow effective release antiretroviral therapy
  • regimen adherence
  • viral reservoirs

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

Cite this

The Promise of Long-Acting Antiretroviral Therapies : From Need to Manufacture. / Gendelman, Howard Eliot; McMillan, JoEllyn M; Bade, Aditya N.; Edagwa, Benson J; Kevadiya, Bhavesh D.

In: Trends in Microbiology, Vol. 27, No. 7, 01.07.2019, p. 593-606.

Research output: Contribution to journalReview article

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