a Department of Pharmaceutics, Ideal College of Pharmacy and Research , University of Mumbai , Mumbai, Maharashtra , India.
b Corporate Quality Assurance , Zydus Cadila , Ahmedabad , Gujarat , India.
Expert Opin Drug Deliv. 2019 Mar;16(3):287-300. doi: 10.1080/17425247.2019.1583206.
Human immune-deficiency virus (HIV) infection causing acquired immune-deficiency syndrome (AIDS) is one of the most life-threatening infections. The central nervous system (CNS) is reported to be the most important HIV reservoir site where the antiretroviral drugs are unable to reach.
This article includes the review about HIV infections, its pathogenesis, HIV infections in CNS, its consequences, current therapies, challenges associated with the existing therapies, approaches to overcome them, CNS delivery of drugs - barriers, transport routes, approaches for transporting drugs across the blood-brain barrier, nasal route of drug delivery, and nose to brain targeting of antiretroviral agents as a potential approach for complete cure of AIDS.
Various approaches are exploited to enhance the drug delivery to the brain for various categories of drugs. However, very few have investigated on the delivery of antiretrovirals to the brain. Targeting antiretrovirals to CNS through oral/nasal routes along with oral/parenteral delivery of drug to the plasma can be a promising approach for an attempt to completely eradicate HIV reservoir and cure AIDS, after clinical trials. Further research is required to identify the exact location of the HIV reservoir in CNS and developing good animal models for evaluation of different newly developed formulations.
人类免疫缺陷病毒（HIV）感染导致获得性免疫缺陷综合征（AIDS），是最具威胁生命的感染之一。据报道，中枢神经系统（CNS）是 HIV 的最重要的储存库，抗逆转录病毒药物无法到达该部位。
本文综述了 HIV 感染及其发病机制、HIV 对 CNS 的感染、其后果、现有疗法、与现有疗法相关的挑战、克服这些挑战的方法、药物向 CNS 的传递-障碍、传输途径、穿过血脑屏障的药物传输方法、药物的鼻腔给药途径，以及抗逆转录病毒药物作为一种潜在的完全治愈艾滋病的方法向大脑的靶向传递。
为了提高各种类药物向大脑的递送，已经利用了多种方法。但是，只有少数研究涉及将抗逆转录病毒药物递送到大脑。通过口服/鼻腔途径将抗逆转录病毒药物靶向 CNS，同时向血浆中口服/肠胃外给予药物，可能是一种很有前途的尝试，可用于彻底清除 HIV 储存库并治愈 AIDS，但需要进行临床试验。需要进一步研究以确定 CNS 中 HIV 储存库的确切位置，并开发良好的动物模型，以评估不同新开发的制剂。
