Clinical Applications of Long-acting Antiretrovirals in HIV/AIDS Care

María Carmen^*
*Correspondence: María Carmen, Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China, Email:

Keywords

Clinical applications • Drug levels • Medication regimens • HIV/AIDS management

Introduction

Human Immunodeficiency Virus (HIV) infection remains a significant global health challenge, affecting millions worldwide. The introduction of antiretroviral therapy (ART) has revolutionized HIV/AIDS management, significantly improving patient outcomes and life expectancy. Traditional ART regimens typically require daily medication adherence, which can be challenging for some patients due to various factors, including pill burden, side effects and stigma associated with HIV/AIDS [1].

Literature Review

Evolution of long-acting antiretrovirals

In recent years, the development of long-acting antiretrovirals (LA-ARVs) has emerged as a promising advancement in HIV/AIDS treatment. Unlike traditional daily oral medications, LA-ARVs offer extended dosing intervals, ranging from monthly to every few months, thereby potentially enhancing treatment adherence and convenience for patients. These formulations utilize various mechanisms to achieve sustained drug levels in the body, such as nanoformulations, injectable depot formulations and implantable devices [2].

Mechanisms of action and pharmacokinetics

LA-ARVs maintain therapeutic drug levels in the bloodstream over prolonged periods, effectively suppressing viral replication and preventing the development of drug resistance. Pharmacokinetic studies have demonstrated that LA-ARVs achieve and maintain effective concentrations in plasma and cellular reservoirs, crucial for controlling HIV replication and reducing viral load [3].

Clinical efficacy and safety

Clinical trials evaluating LA-ARVs have shown comparable efficacy to traditional ART regimens in maintaining viral suppression and immunological recovery among treatment-naïve and treatment-experienced patients. Furthermore, LA-ARVs offer potential benefits such as reduced pill burden, improved treatment adherence and enhanced quality of life. Safety profiles have generally been favorable, with common adverse effects including injection site reactions and transient mild-to-moderate systemic reactions [4].

Patient considerations and challenges

While LA-ARVs represent a significant advancement, several considerations and challenges remain. Patient selection criteria, including adherence history and viral resistance profiles, play a crucial role in determining the appropriateness of LA-ARV therapy. Additionally, healthcare infrastructure, cost implications and regulatory approvals are pivotal factors influencing the adoption and accessibility of these formulations in clinical practice. The evolving landscape of LA-ARVs continues to expand, with ongoing research focusing on novel formulations, combination therapies and strategies to optimize treatment outcomes. Future directions include exploring personalized approaches to HIV/AIDS care, integrating LA-ARVs into comprehensive treatment protocols and addressing global disparities in access to advanced therapies [5,6].

Discussion

Long-acting antiretrovirals (LA-ARVs) represent a significant advancement in HIV/AIDS care, offering several clinical benefits over daily oral medications. These formulations, administered less frequently (e.g., monthly or quarterly), enhance medication adherence by reducing the burden of daily pill-taking. This is crucial for maintaining viral suppression and preventing drug resistance. In clinical practice, LA-ARVs provide a more convenient treatment option for patients, potentially improving quality of life by reducing treatmentrelated stigma and allowing for greater flexibility in managing HIV/AIDS. They are particularly beneficial for individuals who struggle with adherence to daily oral regimens due to lifestyle factors or personal challenges.

Moreover, LA-ARVs offer healthcare providers an effective tool to simplify treatment plans and enhance patient outcomes through consistent viral suppression. Ongoing research aims to expand the range of available longacting formulations and optimize their efficacy and safety profiles, further advancing the field of HIV/AIDS management. Overall, the integration of longacting antiretrovirals into HIV/AIDS care represents a promising direction in improving treatment adherence, reducing healthcare disparities and ultimately achieving better long-term health outcomes for patients globally.

Conclusion

Long-acting antiretroviral represent a paradigm shift in HIV/AIDS management, offering potential advantages in treatment adherence, efficacy and patient convenience. As research and development progress, continued collaboration among healthcare providers, researchers and policymakers will be essential in harnessing the full potential of LA-ARVs to improve outcomes and quality of life for individuals living with HIV/AIDS globally.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Betsy, Sambai, Loice W. Mbogo, Aliza Monroe Wise and Natasha T. Ludwig Barron et al. “Participation in methadone programs improves antiretroviral uptake and HIV viral suppression among people who inject drugs in Kenya.” J AIDS Clin Res 134 (2022): 108587.

   Google Scholar, Crossref, Indexed at

2. Sean, M. Hughes, Claire N. Levy, Fernanda L. Calienes and Joanne D. Stekler, et al. “Treatment with commonly used antiretroviral drugs induces a type i/iii interferon signature in the gut in the absence of HIV infection.” J AIDS Clin Res 1 (2020): 100096

   Google Scholar, Crossref, Indexed at

3. Suzette, Glasner, Kevin Patrick, Michele Ybarra and Alexandra Venegas, et al. “Promising outcomes from a cognitive behavioral therapy text-messaging intervention targeting drug use, antiretroviral therapy adherence, and HIV risk behaviors among adults living with HIV and substance use disorders.” J AIDS Clin Res 231 (2022): 109229

   Google Scholar, Crossref, Indexed at

4. JennyI, versen, Salmanul Hasan Qureshi, Malika Zafar and Machteld Busz, et al. “Adherence to antiretroviral therapy among HIV positive men who inject drugs in Pakistan.”J AIDS Clin Res 96 (2021): 103281

   Google Scholar, Crossref, Indexed at

5. Halima, Dao, Lynne M. Mofenson, Rene Ekpini and Matthew Barnhart, et al. “International recommendations on antiretroviral drugs for treatment of HIV-infected women and prevention of mother-to-child HIV transmission in resource-limited settings: 2006 update.” J AIDS Clin Res 197 (2007): S42-S55

   Google Scholar, Crossref, Indexed at

6. Suzette, Glasner, Kevin Patrick, Michele Ybarra and Alexandra Venegas, et al. “Promising outcomes from a cognitive behavioral therapy text-messaging intervention targeting drug use, antiretroviral therapy adherence, and HIV risk behaviors among adults living with HIV and substance use disorders.” J AIDS Clin Res 231 (2022): 109229

   Google Scholar, Crossref, Indexed at