Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infection

Christine Katlama, Robert MurphyPierre et Marie Curie Université – Paris 6, Service de Maladies Infectieuses et Tropicales, Paris, FranceAbstract: Integrase is an essential HIV-1-specific enzyme that is an active target for antiretroviral drug development. Recently, a ne...

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Main Authors: Christine Katlama, Robert Murphy
Format: Article
Language:English
Published: Dove Medical Press 2009-04-01
Series:Therapeutics and Clinical Risk Management
Online Access:http://www.dovepress.com/emerging-role-of-integrase-inhibitors-in-the-management-of-treatment-e-a3087
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author Christine Katlama
Robert Murphy
author_facet Christine Katlama
Robert Murphy
author_sort Christine Katlama
collection DOAJ
description Christine Katlama, Robert MurphyPierre et Marie Curie Université – Paris 6, Service de Maladies Infectieuses et Tropicales, Paris, FranceAbstract: Integrase is an essential HIV-1-specific enzyme that is an active target for antiretroviral drug development. Recently, a new class of drugs that specifically inhibits strand transfer, one of the three steps of HIV integration into the host DNA, has been developed. Two drugs in this class have reached late stages of development for use in HIV-1 infected individuals: raltegravir, which has just been approved for use in treatment-experienced patients, and elvitegravir, currently in phase III trials. Both are potent with an IC50 in the 30 nM range and active in vitro against wild type as well as in strains highly resistant to all other existing classes of drugs. Clinical trials in both treatment-naïve and -experienced patients have demonstrated raltegravir to be highly effective with an excellent tolerability profile and no specific clinical or metabolic side effects. Longer follow up is necessary to ensure this early safety profile is sustained. The rapid rate of viral decay observed with raltegravir challenges the current understanding of HIV-1 turnover and may open new strategies for long term treatment and management of infected patients.Keywords: integrase inhibitors, antiretroviral therapy, treatment failure, raltegravir, elvitegravir
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spelling doaj.art-e89f413151e742c58cb89beaed3d52e62022-12-22T04:07:18ZengDove Medical PressTherapeutics and Clinical Risk Management1176-63361178-203X2009-04-012009default331340Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infectionChristine KatlamaRobert MurphyChristine Katlama, Robert MurphyPierre et Marie Curie Université – Paris 6, Service de Maladies Infectieuses et Tropicales, Paris, FranceAbstract: Integrase is an essential HIV-1-specific enzyme that is an active target for antiretroviral drug development. Recently, a new class of drugs that specifically inhibits strand transfer, one of the three steps of HIV integration into the host DNA, has been developed. Two drugs in this class have reached late stages of development for use in HIV-1 infected individuals: raltegravir, which has just been approved for use in treatment-experienced patients, and elvitegravir, currently in phase III trials. Both are potent with an IC50 in the 30 nM range and active in vitro against wild type as well as in strains highly resistant to all other existing classes of drugs. Clinical trials in both treatment-naïve and -experienced patients have demonstrated raltegravir to be highly effective with an excellent tolerability profile and no specific clinical or metabolic side effects. Longer follow up is necessary to ensure this early safety profile is sustained. The rapid rate of viral decay observed with raltegravir challenges the current understanding of HIV-1 turnover and may open new strategies for long term treatment and management of infected patients.Keywords: integrase inhibitors, antiretroviral therapy, treatment failure, raltegravir, elvitegravirhttp://www.dovepress.com/emerging-role-of-integrase-inhibitors-in-the-management-of-treatment-e-a3087
spellingShingle Christine Katlama
Robert Murphy
Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infection
Therapeutics and Clinical Risk Management
title Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infection
title_full Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infection
title_fullStr Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infection
title_full_unstemmed Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infection
title_short Emerging role of integrase inhibitors in the management of treatment-experienced patients with HIV infection
title_sort emerging role of integrase inhibitors in the management of treatment experienced patients with hiv infection
url http://www.dovepress.com/emerging-role-of-integrase-inhibitors-in-the-management-of-treatment-e-a3087
work_keys_str_mv AT christinekatlama emergingroleofintegraseinhibitorsinthemanagementoftreatmentexperiencedpatientswithhivinfection
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