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


OBJECTIVE
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.


CONCLUSIONS
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.
Marr
Patricia
P
University Health Network, Immunodeficiency Clinic, 13 North, Room 1314, 200 Elizabeth Street, Toronto, ON M5G2C4, Canada. patricia.marr@uhn.on.ca
Walmsley
Sharon
S
D017326:Clinical Trials, Phase III as Topic; D004334:Drug Administration Schedule; D004347:Drug Interactions; D024921:Drug Resistance, Multiple, Viral; D000077560:Enfuvirtide; D015700:HIV Envelope Protein gp41 / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D023581:HIV Fusion Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D010446:Peptide Fragments / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011358:Product Surveillance, Postmarketing; D011788:Quality of Life
D015700:HIV Envelope Protein gp41; D023581:HIV Fusion Inhibitors; D010446:Peptide Fragments; D000077560:Enfuvirtide