Shin Young Hyun, Park Chul Min, Yoon Cheol Hee
Division of Chronic Viral Disease Research, Center for Emerging Virus Research, Korea National Institute of Health, Chungbuk, Korea.
Center for Convergent Research of Emerging Virus Infection, Korea Research Institute of Chemical Technology, Daejeon, Korea.
Infect Chemother. 2021 Mar;53(1):29-45. doi: 10.3947/ic.2020.0100.
Treatment with highly active antiretroviral therapy (HAART) can prolong a patient's life-span by disrupting pivotal steps in the replication cycle of the human immunodeficiency virus-1 (HIV-1). However, drug resistance is emerging as a major problem worldwide due to the prolonged period of treatment undergone by HIV-1 patients. Since the approval of zidovudine in 1987, over thirty antiretroviral drugs have been categorized into the following six distinct classes based on their biological function and resistance profiles: (1) nucleoside analog reverse-transcriptase inhibitors; (2) non-nucleoside reverse transcriptase inhibitors; (3) integrase strand transferase inhibitors; (4) protease inhibitors; (5) fusion inhibitors; and (6) co-receptor antagonists. Additionally, several antiretroviral drugs have been developed recently, such as a long active drug, humanized antibody and pro-drug metabolized into an active form in the patient's body. Although plenty of antiretroviral drugs are beneficially used to treat patients with HIV-1, the ongoing efforts to develop antiretroviral drugs have overcome the drug resistances, adverse effects, and limited adherence of drugs observed in previous drugs to some extent. Furthermore, studies focused on agents targeting latent HIV-1 reservoirs should be strengthened, as that may lead to eradication of HIV-1.
高效抗逆转录病毒疗法(HAART)通过干扰人类免疫缺陷病毒1型(HIV-1)复制周期中的关键步骤,可以延长患者的寿命。然而,由于HIV-1患者接受治疗的时间延长,耐药性已成为全球范围内的一个主要问题。自1987年齐多夫定获批以来,根据其生物学功能和耐药谱,已有三十多种抗逆转录病毒药物被分为以下六个不同类别:(1)核苷类似物逆转录酶抑制剂;(2)非核苷逆转录酶抑制剂;(3)整合酶链转移抑制剂;(4)蛋白酶抑制剂;(5)融合抑制剂;(6)共受体拮抗剂。此外,最近还开发了几种抗逆转录病毒药物,如长效活性药物、人源化抗体和在患者体内代谢为活性形式的前体药物。尽管大量抗逆转录病毒药物被有益地用于治疗HIV-1患者,但目前开发抗逆转录病毒药物的努力在一定程度上克服了先前药物中观察到的耐药性、不良反应和药物依从性有限的问题。此外,应加强针对潜伏HIV-1储存库的药物研究,因为这可能导致HIV-1的根除。