title: Potential for new antiretrovirals to address unmet needs in the management of HIV-1 infection.
abstract: Despite the myriad advances in antiretroviral therapy since the original highly active antiretroviral therapy regimens were developed, there remain numerous important and pressing unmet needs that, if addressed, would substantially improve the quality of life and longevity of HIV-infected patients. The most achievable goals of antiretroviral (ARV) therapy in the near future are likely to be continued reduction in HIV-related morbidity and mortality; improved quality of life; and restoration and preservation of immune function: all of which are most effectively achieved through sustained suppression of HIV-1 RNA. The ability to achieve long-term viral load reduction will require new ARVs with few, manageable toxicities, and medications that are convenient to adhere to, with few drug interactions. This is particularly true for the large number of highly treatment-experienced patients in whom HIV has developed resistance to one or more ARVs. Development of therapies that allow convenient dosing schedules, that do not necessitate strict adherence to meal-related timing restrictions, and that remain active in the face of resistance mutations is paramount, and remains a significant unmet need. Of the large number of ARVs currently in development, this article focuses on three agents recently approved that have shown particular promise in addressing some of these unmet needs: the novel non-nucleoside reverse transcriptase inhibitor etravirine; the CCR5 antagonist maraviroc; and the integrase inhibitor raltegravir.
authors.affiliation: HIV Research Chelsea & Westminster Hospital, London, United Kingdom. gm@moyleg.demon.co.uk
authors.forename: Graeme
authors.initials: G
authors.lastname: Moyle
authors.forename: Jose
authors.initials: J
authors.lastname: Gatell
authors.forename: Carlo-Federico
authors.initials: CF
authors.lastname: Perno
authors.forename: Winai
authors.initials: W
authors.lastname: Ratanasuwan
authors.forename: Mauro
authors.initials: M
authors.lastname: Schechter
authors.forename: Christos
authors.initials: C
authors.lastname: Tsoukas
mesh_terms: D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000639:trends*; D004347:Drug Interactions; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D015337:Multicenter Studies as Topic; D011480:Protease Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D044966:Anti-Retroviral Agents; D011480:Protease Inhibitors