An In-depth Review Of The Drugs Used For Treatment Of AIDS

Acquired Immune Deficiency Syndrome, also known as "AIDS", is a globally prevalent infectious disease caused by human immunodeficiency virus (HIV) infection. Since HIV was first discovered in humans in 1983, nearly 40 million people have died due to HIV infection and AIDS-related diseases. In the mid-1990s, the FDA approved non-nucleoside reverse transcriptase inhibitors and protease inhibitors for clinical use, ushering in the era of combined antiretroviral therapy (ART). However, due to the inability of ART to completely remove the HIV virus, the long-term daily oral administration of multiple drugs, adverse drug reactions, viral resistance, and inability to guarantee patient compliance, there are still significant clinical needs for the treatment of AIDS.

Long-acting injectable drugs

With the clinical application and promotion of ART, AIDS has been transformed into a chronic disease that requires lifelong treatment. All currently approved drugs need to be taken daily, and some drugs used for treatment of AIDS need to be taken 2 or 3 times a day. The frequency of dosing is high, and long-term treatment will inevitably bring toxic side effects and produce drug-resistant viruses. In addition, medication adherence is also a serious problem. Many patients experience treatment fatigue after years of daily ART. When it comes to combined factors of mental illness, substance abuse, limited economic status, discrimination, poor social support, complex treatment regimens, and excessive pills, long-term daily medication adherence is even more of a challenge for people living with HIV and AIDS. When medication adherence is insufficient, the level of drug exposure will not be able to effectively inhibit HIV replication, thereby increasing the possibility of drug-resistant viruses. Long-acting drugs used for treatment of AIDS or sustained-release formulations may provide new options as a new strategy to address poor patient compliance and treatment fatigue. There is no consensus on the definition of long-acting drugs used for treatment of AIDS and the optimal dosing frequency, but it is certain that these drugs have long half-lives, which can be achieved by sustained-release preparations, drugs with long half-lives, or metabolites Has biological activity. At present, no long-acting drugs used for treatment of AIDS have been approved for marketing, but a series of long-acting injection drugs have entered the late clinical development stage. The launch of these long-acting injectable drugs, especially the combined dosing regimen consisting of multiple long-acting drugs, will bring another revolutionary change to the treatment of AIDS, replacing the treatment of daily oral drugs.

Drugs with new mechanisms of action

The evolution of virus resistance has occurred in all drugs currently in clinical use, even including the latest integrase inhibitor DTG, subjects whose treatment failed inevitably developed drug-resistant viruses. The increasing incidence of cross-resistance and multi-resistance further limits the use of other varieties of the same drug. Long-term antiviral therapy puts forward higher requirements for drug safety and resistance barrier, and patients who have developed drug resistance and lack tolerance also need more drug options. Discover and identify new HIV drug targets, explore new mechanisms of action, develop more safe, effective and well-tolerated new drugs, and provide patients with more dosing regimens, especially for multidrug-resistant patients. It will be an important direction for the development of drugs used for treatment of AIDS in the future. In the past 10 years, the research and development of integrase inhibitors and compound fixed-dose drugs have achieved great success. Although there is no anti-HIV drug with a new mechanism of action, pharmaceutical companies have been actively exploring, and a series of innovative drugs have entered the late clinical stage. In the development stage, it is expected that in the near future, multiple innovative drugs will be approved, enriching the antiviral drug pipeline.

Conclusion

Over the past 30 years, global AIDS prevention and treatment have achieved great success. The currently marketed anti-HIV drugs cannot meet the needs of anti-viral treatment, especially in China, the types of anti-viral drugs available are limited, and patients with multi-drug resistance may have no drug available. clinical needs. Due to the lack of effective vaccines and methods to eradicate HIV virus, long-term antiretroviral therapy still faces severe drug side effects, generation and spread of drug-resistant viruses, poor patient compliance, and the inconvenience of daily oral medication. challenge. The innovation and progress of drug research and development are crucial to the eradication of AIDS. Human beings have been actively exploring new treatment methods, looking for new HIV drug targets and new drugs targeting such targets, especially drugs with a new mechanism of action. The development of high-efficiency, low-toxicity, high-resistance-barrier, easy-to-use, and well-compliant anti-HIV drugs is the goal that scientists have always pursued.