Long-Acting Antiretrovirals: Where Are We now?
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Purpose of Review
Current HIV treatment options require daily use of combination antiretroviral drugs. Many persons living with HIV experience treatment fatigue and suboptimal adherence as a result. Long-acting antiretroviral drugs are being developed to expand options for HIV treatment. Here, we review the agents in development, and evaluate data from recent clinical trials. In addition, we anticipate challenges to successful widespread use of long-acting antiretrovirals.
Parenteral nanosuspensions of cabotegravir and rilpivirine, and dapivirine vaginal ring are the farthest in clinical development. Long-acting modalities in earlier development stages employ drug-loaded implants, microparticles, or targeted mutagenesis, among other innovations.
Long-acting antiretroviral drugs promise new options for HIV prevention and treatment, and ways to address poor adherence and treatment fatigue. Further studies will identify the long-acting agents or combinations that are suitable for routine use. Creative solutions will be needed for anticipated implementation challenges.
KeywordsLong-acting antiretrovirals HIV treatment HIV prevention Pre-exposure prophylaxis
Compliance with Ethical Standards
Conflict of Interest
Amesika N. Nyaku and Sean G. Kelly report no conflict.
Babafemi O.Taiwo has served as a consultant to ViiV, GlaxoSmithKline (GSK), and Gilead Sciences, and has received research support to Northwestern University from ViiV Healthcare.
Human and Animal Rights and Informed Consent
This manuscript does not contain studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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