Long-acting antiretrovirals: a new era for the management and prevention of HIV infection.
Details
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State: Public
Version: Final published version
License: CC BY-NC-SA 4.0
State: Public
Version: Final published version
License: CC BY-NC-SA 4.0
Serval ID
serval:BIB_C31B6241296B
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Long-acting antiretrovirals: a new era for the management and prevention of HIV infection.
Journal
The Journal of antimicrobial chemotherapy
ISSN
1460-2091 (Electronic)
ISSN-L
0305-7453
Publication state
Published
Issued date
02/02/2022
Peer-reviewed
Oui
Volume
77
Number
2
Pages
290-302
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
The long-acting antiretroviral cabotegravir and rilpivirine combination has just received FDA, EMA and Health Canada approval. This novel drug delivery approach is about to revolutionize the therapy of people living with HIV, decreasing the 365 daily pill burden to only six intramuscular injections per year. In addition, islatravir, a first-in-class nucleoside reverse transcriptase translocation inhibitor, is intended to be formulated as an implant with a dosing interval of 1 year or more. At present, long-acting antiretroviral therapies (LA-ARTs) are given at fixed standard doses, irrespectively of the patient's weight and BMI, and without consideration for host genetic and non-genetic factors likely influencing their systemic disposition. Despite a few remaining challenges related to administration (e.g. pain, dedicated medical procedure), the development and implementation of LA-ARTs can overcome long-term adherence issues by improving patients' privacy and reducing social stigma associated with the daily oral intake of anti-HIV treatments. Yet, the current 'one-size-fits-all' approach does not account for the recognized significant inter-individual variability in LA-ART pharmacokinetics. Therapeutic drug monitoring (TDM), an important tool for precision medicine, may provide physicians with valuable information on actual drug exposure in patients, contributing to improve their management in real life. The present review aims to update the current state of knowledge on these novel promising LA-ARTs and discusses their implications, particularly from a clinical pharmacokinetics perspective, for the future management and prevention of HIV infection, issues of ongoing importance in the absence of curative treatment or an effective vaccine.
Keywords
Anti-HIV Agents, Anti-Retroviral Agents/therapeutic use, HIV Infections/drug therapy, HIV Infections/prevention & control, HIV-1, Humans, Pyridones/therapeutic use, Rilpivirine
Pubmed
Web of science
Open Access
Yes
Funding(s)
Swiss National Science Foundation / 324730_192449
Create date
13/09/2021 9:50
Last modification date
21/11/2022 8:26