New HIV drugs/regimens

At one particular session of the 2nd Asia Pacific AIDS & Co-infections Conference (APACC) that took place from 1 to 3 June 2017 in Hong Kong, Dr. Dan Kuritzkes (Harvard Medical School, USA) started his presentation by asking the question, 'Why do we need new drugs?'

The answers being:

• Side effects of current therapies.
• Long term toxicities of current ART.
• Resistance issues.
• Need for less frequent dosing.

He then went on to discuss new medications in development/trials.

DORAVIRINE (NNRTI) — This drug is active against HIV carrying the common NNRTI resistance mutations, it has low potential for drug-drug interactions and has the same efficacy as Effavirenz.

BICTEGRAVIR (INSTI) — Active against wild-type and strains carrying the common INSTI resistance mutations.

Dan went on to discuss the pros and cons of different types of treatment delivery such as injectables.

Pros                                               Cons

Monthly dosing                                 The injection itself may put clients off

More convenient                               Long term tolerability

Less internal stigma                          Long half life

Better adherance                              Cannot be self-administered

An interesting snippet was that TRUVADA is being researched as an injectable. This ties in with Dr. Zhang's presentation who stated that TRUVADA as a single tablet wasnt available in China and called for a new way to deliver this medication especially in the setting of PrEP. Dan mentioned a few other drugs in development but didnt elaborate much on them. These being:

IBALIZUMAB, FOSTEMSAVIR and PRO140.

The summary of Dr. Kuritzkes' session is:

• There are new drugs in several classes undergoing clinical trials.
• Different delivery systems are being researched.
• Novel viral and cellular targets are being explored rather than the traditional classes.
• 2 Drug ART regimens could became the norm rather than 3 drug ART.