Reassessment of enfuvirtide's role in the management of HIV-1 infection

Abstract

Background: The development of new protease inhibitors, new non-nucleoside reverse transcriptase inhibitors and novel therapeutic drug classes has dramatically changed the approach to managing HIV-1 patients with multidrug resistant virus. This has led many clinicians to reevaluate the clinical utility of enfuvirtide. Objectives: To summarize recent literature on enfuvirtide and to reassess enfuvirtide's role in the management of HIV-1 infection. Methods: MEDLINE (1990 to February Week 2 2008) and EMBASE (1990 to 2008 week 8) databases were searched using the following terms: ‘enfuvirtide’, ‘Fuzeon’, ‘T20’, ‘HIV fusion inhibitors’, and ‘HIV entry inhibitor’; limits: English language. Reference lists of articles deemed relevant were hand searched for additional publications. Significant abstracts from recent international HIV conferences were also identified. Conclusion: Enfuvirtide can optimize the response to new combinations of HIV-1 drug regimens in multiresistant patients. Its inclusion as an active agent is effective but use is impacted by its high cost, inconvenient route of administration and cosmetic side-effect profile.

Keywords::

• anti-HIV agents
• antiretroviral therapy
• enfuvirtide
• Fuzeon
• HIV entry inhibitor
• HIV fusion inhibitor
• HIV infection
• salvage therapy
• treatment-experienced patients
• T-20