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30年的艾滋病病毒治疗:当前及未来的抗病毒药物靶点

30 years of HIV therapy: Current and future antiviral drug targets.

作者信息

Nuwagaba Julius, Li Jessica A, Ngo Brandon, Sutton Richard E

机构信息

Section of Infectious Diseases, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA.

Section of Infectious Diseases, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA.

出版信息

Virology. 2025 Feb;603:110362. doi: 10.1016/j.virol.2024.110362. Epub 2024 Dec 17.

Abstract

Significant advances in treatment have turned HIV-1 into a manageable chronic condition. This has been achieved due to highly active antiretroviral therapy (HAART), involving a combination regimen of medications, including drugs that target Reverse Transcriptase, Protease, Integrase, and viral entry, explored in this review. This paper also highlights novel therapies, such as Lenacapavir, and avenues toward functional cure targeting the CCR5 co-receptor, including the Δ32 mutation. Challenges of HAART include lifelong adherence, toxicity, drug interactions, and drug resistance. Future therapeutic strategies may focus on underexplored antiviral targets. HIV-1 Tat and Rev proteins have essential HIV-1 regulatory functions of transcriptional elongation of the viral long terminal repeat and nuclear export of intron-containing HIV-1 RNA, respectively. These non-enzymatic proteins should thus be investigated to identify small molecules that inhibit HIV-1 replication, without causing undue toxicity. Continued innovation is essential to address therapeutic gaps and bring us closer to a potential HIV-1 cure.

摘要

治疗方面的重大进展已将HIV-1转变为一种可控制的慢性病。这得益于高效抗逆转录病毒疗法(HAART),该疗法采用联合用药方案,包括本文所探讨的针对逆转录酶、蛋白酶、整合酶和病毒进入的药物。本文还重点介绍了新型疗法,如伦那卡帕韦,以及针对CCR5共受体实现功能性治愈的途径,包括Δ32突变。HAART的挑战包括终身坚持用药、毒性、药物相互作用和耐药性。未来的治疗策略可能会聚焦于尚未充分探索的抗病毒靶点。HIV-1 Tat蛋白和Rev蛋白分别对病毒长末端重复序列的转录延伸和含内含子的HIV-1RNA的核输出具有至关重要的HIV-1调节功能。因此,应该对这些非酶蛋白进行研究,以确定能够抑制HIV-1复制且不会造成过度毒性的小分子。持续创新对于填补治疗空白并使我们更接近潜在的HIV-1治愈方法至关重要。

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