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Future Antiretrovirals, Immune-Based Strategies, and Therapeutic Vaccines 

Future Antiretrovirals, Immune-Based Strategies, and Therapeutic Vaccines
Chapter:
Future Antiretrovirals, Immune-Based Strategies, and Therapeutic Vaccines
Author(s):

Adrian Majid

and Bruce L. Gilliam

DOI:
10.1093/med/9780190493097.003.0023
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date: 08 December 2019

Highly active antiretroviral therapy remains the mainstay of treatment for patients chronically infected with HIV. Novel drugs, both within existing classes and new ones, are in various stages of development and testing. New medications within existing classes of antiretroviral agents are in clinical trials and will likely offer activity against resistant HIV-1 strains and provide alternatives for combination pill therapy. Novel therapeutics including oral attachment inhibitors and monoclonal antibody treatments continue to show efficacy against HIV-1 and progress in clinical trials. Tenofovir alafenamide is a prodrug that produces higher intracellular levels of tenofovir diphosphate with likely less renal and bone toxicity. Among traditional classes of HIV treatment, both doravirine (a non-nucleoside reverse transcriptase inhibitor) and cabotegravir (an integrase strand inhibitor) are newer agents with activity against resistant virus. Maturation inhibitors are a new class of treatment that block protease cleavage, leading to the release of an immature virion.

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