As discussed in our previous post about human immunodeficiency virus (HIV), a cure does not exist at the moment for this potentially life-threatening disease. However, antiretroviral therapy (ART) effectively manages symptoms and protects against transmission. This post will provide an overview of ART medications and how they aid in HIV disease management.
ART is a therapy that consists of combining three or more antiretroviral medications. There are specific medications designed to target unique characteristics of HIV - entry, integrase, protease, and reverse transcriptase inhibitors (RTIs) [1,2]:
Entry inhibitors prevent the entry of HIV to the cells [3].
Integrase inhibitors prevent the integration of viral DNA [5-7].
Protease inhibitors block the assembly process of a viral particle [6]
RTIs block reverse transcriptase, preventing the production of viral DNA [4].
The main types of RTIs are: nucleoside, nucleotide, non-nucleoside and non-nuleotide. Nucleoside/nucleotide RTIs are incorporated into DNA and stops the synthesis of viral DNA. Non-nucleoside/non-nucleotide RTIs bind to reverse transcriptase, halting its movement, and consequently ceasing DNA synthesis [4].
Figure 1. Schematic description of the mechanism of the four classes of currently available antiviral drugs against HIV: entry inhibitors, reverse-transcriptase inhibitors, integrase inhibitors, and protease inhibitors.
Once the host is infected, there are many viruses at all different stages of its life cycle. Therefore, having multiple medications that target each step of the cycle simultaneously is much more effective. ART reduces the quantity of HIV to undetectable amounts, allowing the infected individuals to fulfill a long and healthy life, as well as protecting their family and loved ones.
Stay tuned for recent developments of HIV vaccines!
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Written by: Hedi
Edited by: Natasha
Figure created by: Hedi
BioDecoded is a volunteer group committed to sharing accurate scientific information. We cannot offer any specific health advice. If you have any doubts about your personal health, please speak with your healthcare professional or family physician. Your doctor can revise your medical history and advise you on the best path to follow. If you have any questions about this topic or would like to learn more, please comment below or send us your questions.
References:
HIV Treatment: The Basics | NIH. Available at: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-treatment-basics (Acessed February 20, 2022).
Arts EJ et al. (2012) . HIV-1 antiretroviral drug therapy. Cold Spring Harb Perspect Med. 2(4). Available at: https://pubmed.ncbi.nlm.nih.gov/22474613/
Rusconi S, et al. (2007). An Update in the Development of HIV Entry Inhibitors. Current Top Med Chem 7(13): 1273-1289. Available at: https://pubmed.ncbi.nlm.nih.gov/17627557/
Patel PH, et al. (2022). Reverse Transcriptase Inhibitors. Front HIV Res. 44-61. Available at: http://www.eurekaselect.com/chapter/8197
Craigie R, et al. (2012). HIV DNA integration. Cold Spring Harb Perspect Med 2(7). Available at: https://pubmed.ncbi.nlm.nih.gov/22762018/
Lv Z, et al. (2015). HIV protease inhibitors: a review of molecular selectivity and toxicity. HIV AIDS 7:95. Available at: https://pubmed.ncbi.nlm.nih.gov/25897264/
Zhao AV, et al. (2022). A clinical review of HIV integrase strand transfer inhibitors (INSTIs) for the prevention and treatment of HIV-1 infection. Retrovirology 19(1):1-30. Available at: https://retrovirology.biomedcentral.com/articles/10.1186/s12977-022-00608-1
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