Contagion Live review
Over the past 3 decades, antiretroviral therapy (ART) has transformed HIV from a universally fatal infection into a manageable chronic disease. Modern integrase strand transfer inhibitor (INSTI)–based regimens achieve virologic suppression in over 90% of treated individuals, resulting in life expectancy comparable to that of the general population. Despite these advances, important limitations remain. With daily oral ART, people with HIV face challenges with adherence and stigma; meanwhile, lifelong therapy contributes to pill fatigue, polypharmacy, and risk of drug resistance.
The next generation of antiretroviral development, therefore, has shifted to prioritize factors beyond antiviral potency alone. ART research and development now greatly considers patient-centered outcomes, progressing toward less frequent dosing to improve patients’ quality of life, fewer active ingredients to minimize toxicity, and the mission of functional cure or remission strategies through targeting HIV reservoirs. The current manufacturing pipeline reflects this paradigm shift. Investigational therapies include nucleoside reverse transcriptase translocation inhibitors (NRTTIs), capsid inhibitors, broadly neutralizing antibodies (bNAbs), immune modulators, and T cell–engaging biologics.
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