The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multiple drugs that act on different viral targets is known as highly active antiretroviral therapy (HAART). HAART decreases the patient's total burden of HIV,maintains function of the immune system,and prevents opportunistic infections that often lead to death. HAART also prevents the transmission of HIV between serodiscordant same-sex and opposite-sex partners so long as the HIV-positive partner maintains an undetectable viral load.
Protease inhibitors (PIs) are medications that act by interfering with enzymes that cleave proteins. Some of the most well known are antiviral drugs widely used to treat HIV/AIDS,hepatitis C and COVID-19. These protease inhibitors prevent viral replication by selectively binding to viral proteases and blocking proteolytic cleavage of protein precursors that are necessary for the production of infectious viral particles.
Ritonavir,sold under the brand name Norvir,is an antiretroviral medication used along with other medications to treat HIV/AIDS. This combination treatment is known as highly active antiretroviral therapy (HAART). Ritonavir is a protease inhibitor,though it now mainly serves to boost the potency of other protease inhibitors. It may also be used in combination with other medications to treat hepatitis C and COVID-19. It is taken by mouth.
Nevirapine (NVP),sold under the brand name Viramune among others,is a medication used to treat and prevent HIV/AIDS,specifically HIV-1. It is generally recommended for use with other antiretroviral medications. It may be used to prevent mother to child spread during birth but is not recommended following other exposures. It is taken by mouth.
Saquinavir,sold under the brand name Invirase among others,is an antiretroviral medication used together with other medications to treat or prevent HIV/AIDS. Typically it is used with ritonavir or lopinavir/ritonavir to increase its effect. It is taken by mouth.
Indinavir is a protease inhibitor used as a component of highly active antiretroviral therapy to treat HIV/AIDS. It is soluble white powder administered orally in combination with other antiviral drugs. The drug prevents protease from functioning normally. Consequently,HIV viruses cannot reproduce,causing a decrease in the viral load. Commercially sold indinavir is indinavir anhydrous,which is indinavir with an additional amine in the hydroxyethylene backbone. This enhances its solubility and oral bioavailability,making it easier for users to intake. It was synthetically produced for the purpose of inhibiting the protease in the HIV virus.
The AIDS Clinical Trials Group network (ACTG) is one of the largest HIV clinical trials organizations in the world,playing a major role in setting standards of care for HIV infection and opportunistic diseases related to HIV and AIDS in the United States and the developing world. The ACTG is composed of,and directed by,leading clinical scientists in HIV/AIDS therapeutic research. The ACTG is funded by the Department of Health and Human Services,National Institutes of Health through the National Institute of Allergy and Infectious Diseases.
Lopinavir is an antiretroviral of the protease inhibitor class. It is used against HIV infections as a fixed-dose combination with another protease inhibitor,ritonavir (lopinavir/ritonavir).
Darunavir (DRV),sold under the brand name Prezista among others,is an antiretroviral medication used to treat and prevent HIV/AIDS. It is generally recommended for use with other antiretrovirals. It is often used with low doses of ritonavir or cobicistat to increase darunavir levels. It may be used for prevention after a needlestick injury or other potential exposure. It is taken by mouth once to twice a day.
The HIV Prevention Trials Network (HPTN) is a worldwide collaborative clinical trials network that brings together investigators,ethicists,community and other partners to develop and test the safety and efficacy of interventions designed to prevent the acquisition and transmission of HIV. HPTN studies evaluate new HIV prevention interventions and strategies in populations and geographical regions that bear a disproportionate burden of infection. The HPTN is committed to the highest ethical standards for its clinical trials and recognizes the importance of community engagement in all phases of the research process.
Elvitegravir (EVG) is an integrase inhibitor used to treat HIV infection. It was developed by the pharmaceutical company Gilead Sciences,which licensed EVG from Japan Tobacco in March 2008. The drug gained approval by the U.S. Food and Drug Administration on August 27,2012,for use in adult patients starting HIV treatment for the first time as part of the fixed dose combination known as Stribild. On September 24,2014,the FDA approved Elvitegravir as a single pill formulation under the trade name Vitekta. On November 5,2015,the FDA approved the drug for use in patients affected with HIV-1 as a part of a second fixed dose combination pill known as Genvoya.
Rilpivirine,sold under the brand names Edurant and Rekambys,is a medication,developed by Tibotec,used for the treatment of HIV/AIDS. It is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) with higher potency,longer half-life and reduced side-effect profile compared with older NNRTIs such as efavirenz.
Camostat is a serine protease inhibitor. Serine protease enzymes have a variety of functions in the body,and so camostat has a diverse range of uses. Camostat is approved in Japan for the treatment of chronic pancreatitis and postoperative reflux esophagitis. The oral proteolytic enzyme inhibitor has been on the market since 1985 under the trade name Foipan Tablets. The manufacturer is Ono Pharmaceutical. The drug is used in the treatment of some forms of cancer and is also effective against some viral infections,as well as inhibiting fibrosis in liver or kidney disease or pancreatitis.
Many major physiological processes depend on regulation of proteolytic enzyme activity and there can be dramatic consequences when equilibrium between an enzyme and its substrates is disturbed. In this prospective,the discovery of small-molecule ligands,like protease inhibitors,that can modulate catalytic activities has an enormous therapeutic effect. Hence,inhibition of the HIV protease is one of the most important approaches for the therapeutic intervention in HIV infection and their development is regarded as major success of structure-based drug design. They are highly effective against HIV and have,since the 1990s,been a key component of anti-retroviral therapies for HIV/AIDS.
Cobicistat,sold under the brand name Tybost,is a medication for use in the treatment of human immunodeficiency virus infection (HIV/AIDS). Its major mechanism of action is through the inhibition of human CYP3A proteins.
Lopinavir/ritonavir (LPV/r),sold under the brand name Kaletra among others,is a fixed-dose combination antiretroviral medication for the treatment and prevention of HIV/AIDS. It combines lopinavir with a low dose of ritonavir. It is generally recommended for use with other antiretrovirals. It may be used for prevention after a needlestick injury or other potential exposure. It is taken by mouth as a tablet,capsule,or solution.
Jeffrey P. Nadler was an American Infectious Diseases and HIV/AIDS expert. His most recent position had been as Acting Director and Assistant Director of the Therapeutics Research Program,Division of AIDS (DAIDS),National Institute of Allergy and Infectious Diseases (NIAID) where he oversaw NIH/NIAID-sponsored national and international HIV/AIDS research.
Cabotegravir,sold under the brand name Vocabria among others,is a antiretroviral medication used for the treatment of HIV/AIDS. It is available in the form of tablets and as an intramuscular injection,as well as in an injectable combination with rilpivirine under the brand name Cabenuva.
Deborah Persaud is a Guyanese-born American virologist who primarily works on HIV/AIDS at Johns Hopkins Children's Center.
Cabotegravir/rilpivirine,sold under the brand name Cabenuva,is a co-packaged antiretroviral medication for the treatment of HIV/AIDS. It contains cabotegravir and rilpivirine in a package with two separate injection vials.
