Advances in nanomedicine drug delivery applications for HIV therapy


Despite significant advances in the treatment of human immunodeficiency virus (HIV), there remain challenges. HIV is a chronic disease and patient adherence to treatment is critical over a lifetime. Poor therapy adherence increases the likelihood of virological failure and emergence of resistant strains of HIV [1]. Poor aqueous drug solubility is a major limitation, negatively impacting oral bioavailability for many antiretroviral drugs [2]. Complete eradication resulting in cure has long been a focus of research efforts but the existence of cellular and anatomical regions where the virus can continue to replicate in subtherapeutic drug concentrations creates sanctuary sites [3], which reseed the blood when therapy is withdrawn [4]. The application of nanomedicine to current and future HIV therapeutic agents may offer bespoke solutions to the issues faced by traditionally formulated drugs. The purpose of this review is to highlight recent advances in the application of nanotechnology to drug delivery as summarized in Figure 1.

A number of nanomedicine strategies are being explored for oral delivery of antiretroviral drugs and have been reviewed previously [5]. Among the current strategies to improve bioavailability of poorly water-soluble drugs are solid drug nanoparticle (SDN) formulations. SDNs of efavirenz were recently generated using a single-step emulsion-templated freeze-drying technique [6]. In vitro–in vivo pharmacokinetic extrapolation predicted that the SDN formulations could achieve similar pharmacokinetics to the standard Sustiva© formulation with a 50% lower dose. These simulations were validated in vivo with pharmacokinetics in rats demonstrating a higher Cmax, Cmin and AUC compared with a conventional preclinical formulation [6].

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