Long-term drugs will revolutionize HIV prevention and treatment – 10/16/2020

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In 1987, just six years after the first described case of AIDS in the world, the first drug to treat HIV infection was licensed in the United States. Since then, more than 30 other drugs have been developed, but the goal now is to make it even easier and eliminate the need for daily pill taking.

The first of all antiretroviral drugs was called Zidovudine, which became better known as AZT. It needed to be taken every 12 hours, for a total of 12 pills a day. And despite the median potency against HIV, the side effects experienced by those taking it made its prolonged use virtually impossible.

This reality was portrayed in the award-winning feature film Dallas Shopping Club, 2013. The film tells the story of a clandestine AZT smuggling network for people with AIDS at an advanced stage, accurately illustrating the difficulty existing at the time to tolerate drugs used against HIV.

Today, fortunately, this is a reality that is already behind us. The drugs used now to treat HIV are far more potent against the virus and have virtually no side effects for most people. But even though the number of pills has been drastically reduced, the approved and available therapeutic options still fundamentally depend on the daily taking of pills.

In Brazil, the vast majority of the nearly 1 million people living with HIV currently take antiretroviral regimens that use 1 or 2 pills a day. This number may seem small when compared to dozens of the past, but for some people, the long-term requirement of taking pills daily can turn into fatigue, poor adherence and even abandonment of treatment.

Thinking about it and the people who have difficulties to correctly adhere to their treatment, in recent years long-term antiretrovirals have become the subject of intense research.

First it was the turn of injectable antiretrovirals, such as Cabotegravir it’s at Rilpivirina, which administered bimonthly intramuscularly, had an excellent performance in clinical trials that evaluated them both in the treatment and prevention (PrEP) of HIV.

Neither use has yet been released by drug regulatory agencies, which should happen in the United States in the coming months. However, pain at the injection site, the main side effect reported by users of these drugs, and the persistence of the detectable drug in an individual’s blood for up to 1 year after stopping the injections, may make its use more widespread in the country. real life context is limited.

More recently, a new antiretroviral called Islatravir gained attention due to its high potency against HIV and favorable profile of side effects, absorption and elimination of the drug, ideal for a candidate for long-acting medication.

In studies on monkeys, the Islatravir showed good results on a pill schedule taken once a week, either for HIV treatment or as Post-Exposure Prophylaxis (PEP). Clinical trials are now underway to evaluate the drug’s performance in preventing and treating HIV in humans.

Last week, during the Glasgow Annual Antiretroviral Conference, in Scotland, the possibility of one day dealing with HIV without the use of pills has gained momentum. The initial results in humans of a new drug called MK-8507, which, similarly to Islatravir, has prolonged action and good profile of side effects.

If everything goes well from now on in clinical trials with this new drug, it can be tested in association with Islatravir for the treatment of HIV in the form of subcutaneous implants changed once a year, in the same way as contraceptive implants.

An antiretroviral implant capable of treating or preventing HIV effectively and safely will also be transformative in the daily confrontation of serophobia that exists in the world. This is because whenever a person has one of these implants applied to their arm, knowing whether or not they live with HIV is no longer important, as we will know that HIV will not be a problem.

Almost 40 years after the first AIDS case, science continues to take its steps towards a world in which all people can find a form of HIV prevention or treatment that fits their context of life.

Don’t be left out of this.

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