Long-acting approaches for delivery of antiretroviral drugs for prevention and treatment of HIV: a review of recent research

ABSTRACT

Introduction

Despite significant advances in treatment and prevention of HIV-1 infection, poor adherence to daily combination antiretroviral therapy (ART) regimens remains a major obstacle toward achieving sustained viral suppression and prevention. Adherence to ART could also be compromised by adverse drug reactions and societal factors that limit access to therapy. Therefore, medicines that aim to improve adherence by limiting ART side effects, frequency of dosing and socially acceptable regimens are becoming more attractive.

Areas covered

This review highlights recent advances and challenges in the development of long-acting drug delivery strategies for HIV prevention and treatment. Approaches for extended oral and transdermal deliveries, microbicides, broadly neutralizing antibodies, and long-acting implantable and injectable deliveries are reviewed.

Expert opinion

Emerging approaches on long-acting antiretroviral therapies and broadly neutralizing antibody technologies are currently at various stages of development. Such efforts, if successful and become broadly accepted by clinicians and users, will provide newer and simpler options for prevention and treatment of HIV infection.

KEYWORDS:

• HIV
• long-acting antiretrovirals
• transdermal delivery
• microbicides
• broadly neutralizing antibodies
• subcutaneous implants
• injectables
• LASER ART

Article highlights

• Desirable features for long-acting drug delivery strategies

• Long-acting strategies for HIV treatment and prevention

• Long-acting slow effective release prodrug approaches for improved intracellular and tissue drug delivery

• Potential role of long-acting formulations in HIV eradication strategies

• Potential implementation challenges for long-acting drug delivery strategies

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by the National Institutes of Health grant1R01AI145542-01A1 (B. Edagwa).