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HIV drug development: the next 25 years

Nature Reviews Drug Discovery volume 6, pages 959–966 (2007)Cite this article

Abstract

The development of drugs for HIV infection began soon after the virus was discovered 25 years ago. Since then, progress has been substantial, but numerous uncertainties persist about the best way to manage this disease. Here we review the current treatment options, consider novel mechanisms that can be exploited for existing drug targets, and explore the potential of novel targets. With a view to the next quarter century, we consider whether drug resistance can be avoided, which drug classes will be favoured over others, which strategies are most likely to succeed, and the potential impact of pharmacogenomics and individualized therapy.

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Figure 1: Replication cycle of HIV with current and possible targets for antiviral intervention.
Figure 2: Adherence to clarithromycin (for Mycobacterium avium infection) in HIV-infected patients, and variability in pharmacokinetics of lopinavir (for HIV infection).

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Acknowledgements

This manuscript includes previously unpublished data from the AIDS Clinical Trials Group (ACTG) Protocol 223 (Figure 2a), and was supported in part by NIH grants AI-27668, AI-068636 and AI-069465.

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  1. Divisions of Clinical Pharmacology and Infectious Diseases, Departments of Medicine, Charles Flexner is at Johns Hopkins University, Pharmacology and Molecular Sciences, and International Health, Osler 503, 600 North Wolfe Street, Baltimore, Maryland 21287-5554, USA. flex@jhmi.edu,

    Charles Flexner

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Competing interests

During the preparation of this manuscript and for 12 months prior, the author received research grant support from Boehringer–Ingelheim Inc., Bristol–Myers Squibb and GlaxoSmithKline; served on scientific advisory boards for Boehringer–Ingelheim Inc., Bristol–Myers Squibb, Inhibitex Inc., Merck Pharmaceuticals, Tibotec Pharmaceuticals and Vertex Pharmaceuticals; and received lecture honoraria from Abbott Laboratories, Gilead Pharmaceuticals and GlaxoSmithKline.

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Flexner, C. HIV drug development: the next 25 years. Nat Rev Drug Discov 6, 959–966 (2007). https://doi.org/10.1038/nrd2336

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