title: Long-Acting Antiretrovirals: Where Are We now?
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA.
authors.forename: Amesika N
authors.initials: AN
authors.lastname: Nyaku
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Vanderbilt University, Nashville, TN, USA.
authors.forename: Sean G
authors.initials: SG
authors.lastname: Kelly
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine & Center for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. b-taiwo@northwestern.edu.|Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA. b-taiwo@northwestern.edu.
authors.forename: Babafemi O
authors.initials: BO
authors.lastname: Taiwo
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D003692:Delayed-Action Preparations / Q000008:administration & dosage*; D055808:Drug Discovery / Q000639:trends; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D000068696:Rilpivirine / Q000008:administration & dosage
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D003692:Delayed-Action Preparations; D000068696:Rilpivirine
keywords: HIV prevention; HIV treatment; Long-acting antiretrovirals; Pre-exposure prophylaxis