Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama 35294-0006, USA.
Curr Opin HIV AIDS. 2009 Nov;4(6):513-7. doi: 10.1097/COH.0b013e328331d3d0.
To provide an update on viral entry inhibitors focusing on recently published clinical trials, the routine clinical use of these medications, and future drug candidates.
Clinical trials and cohort studies support the efficacy of both enfuvirtide and maraviroc in the management of treatment-experienced patients. In clinical practice, tolerability issues, particularly injection site reactions, have limited the clinical use of enfuvirtide. Providers should be aware of the need for tropism determination and dosing requirements for maraviroc. The novel chemokine (C-C motif) receptor 5-blocking agent, vicriviroc, has shown promise and is currently in phase III clinical development.
The rapid pace of scientific discovery and pharmaceutical development has led to the release of several novel and well tolerated antiretroviral agents, with activity against resistant isolates. Entry inhibitors remain a critical therapeutic option for treatment-experienced patients. Providers need to be familiar with these agents, and future drug development should be encouraged.
重点介绍近期发表的临床试验、这些药物的常规临床应用以及未来的候选药物，以更新病毒进入抑制剂的相关内容。
临床试验和队列研究支持恩夫韦肽和马拉维若在治疗经验丰富的患者管理中的疗效。在临床实践中，由于耐受性问题，特别是注射部位反应，限制了恩夫韦肽的临床应用。临床医生应该了解对趋化因子（C-C 基序）受体 5 阻断剂马拉维若进行嗜性测定和剂量需求的必要性。新型趋化因子（C-C 基序）受体 5 阻断剂维喹罗，具有良好的疗效，目前正处于 III 期临床开发阶段。
科学发现和药物研发的快速步伐导致了几种新型、耐受性良好的抗逆转录病毒药物的释放，对耐药株具有活性。进入抑制剂仍然是治疗经验丰富的患者的重要治疗选择。临床医生需要熟悉这些药物，鼓励未来的药物研发。
