Purpose of Review
Combination antiretroviral therapy (cART) has had dramatic effects on morbidity and mortality for persons living with HIV (PLWH). Despite significant progress in treatment efficacy, tolerability, and reducing pill burden, new agents are needed to address issues of resistance, drug-drug interactions, end organ disease, and adherence. This review covers novel ART agents recently approved or in development.
Capsid inhibitors (CAI) demonstrate high potency and potential for extended-duration dosing in pre-clinical trials. While previous maturation inhibitors (MI) were hampered by issues of drug resistance, a recent phase IIa trial for a second-generation MI demonstrated promising antiviral activity. A phase I trial to evaluate a transdermal implant of islatravir, a nucleoside reverse transcriptase translocation inhibitor (NRTTI), maintained concentrations above the target pharmacokinetic threshold at 12 weeks. The attachment inhibitor fostemsavir is available in the USA for compassionate use in multi-drug-resistant (MDR) HIV.
New antiretroviral agents show promise for both extended-duration dosing and MDR HIV.
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Mary Catherine Cambou was supported by the UCLA Postdoctoral Fellowship Training Program in Global HIV Prevention Research (Currier and Gorbach, PIs); T32MH080634. Dr. Landovitz was supported by the UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) NIMH grant P30MH58107.
Conflict of Interest
Raphael J. Landovitz has received research grants from, and served as a consultant to Gilead Sciences; and served as a consultant to Merck and Co, Inc. Dr. Landovitz received honoraria and travel support from Gilead Sciences, Merck, Inc, and Roche.
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Cambou, M.C., Landovitz, R.J. Novel Antiretroviral Agents. Curr HIV/AIDS Rep (2020). https://doi.org/10.1007/s11904-020-00486-2
- New antiretrovirals
- Capsid inhibitors
- Maturation inhibitors
- Nucleoside reverse transcriptase translocation inhibitors
- Anti-CD4 antibodies