Targets for Inhibition of HIV Replication: Entry, Enzyme Action, Release and Maturation

Inhibition of HIV replication initially targeted viral enzymes, which are exclusively expressed by the virus and not present in the human cell. The development of reverse transcriptase (RT) inhibitors started with the discovery of antiretroviral activity of the nucleoside analog zidovudine in March 1987. Currently, six major classes of antiretroviral drugs are used for the treatment of HIV-infected patients: the RT inhibitors, nucleoside inhibitors and nonnucleoside inhibitors, the protease inhibitors, the integrase inhibitor raltegravir, the fusion inhibitor enfuvirtide (T-20), and the chemokine receptor 5 antagonist maraviroc. A seventh class, the maturation inhibitors, has not yet been approved as their effectiveness is impaired by HIV-1 polymorphisms naturally occurring in 30– 40% of HIV-1 therapy-naive isolates. The use of antiretroviral combination therapy has proven to be effective in delaying progression to AIDS and to reconstitute the immune system of HIV-infected individuals. During the last 5 years, the introduction of the newest antiretrovirals has increased treatment efficacy tremendously. However, the development and accumulation of resistance to all antiretroviral drug Published online: January 24, 2012 Saleta Sierra-Aragón Institute of Virology Fuerst-Pueckler Strasse 56 DE–50935 Cologne (Germany) Tel. +49 221 4788 7261, E-Mail saleta.sierra-aragon @ uk-koeln.de © 2012 S. Karger AG, Basel 0300–5526/12/0552–0084$38.00/0 Accessible online at: www.karger.com/int D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /1 9/ 20 17 4 :0 0: 22 P M