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A mechanistic theory to explain the efficacy of antiretroviral therapy

Nature Reviews Microbiology volume 12, pages 772–780 (2014)Cite this article

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Abstract

In the early years of the AIDS epidemic, a diagnosis of HIV-1 infection was equivalent to a death sentence. The development of combination antiretroviral therapy (cART) in the 1990s to combat HIV-1 infection was one of the most impressive achievements of medical science. Today, patients who are treated early with cART can expect a near-normal lifespan. In this Opinion article, we propose a fundamental theory to explain the mechanistic basis of cART and why it works so well, including a model to assess and predict the efficacy of antiretroviral drugs alone or in combination.

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Figure 1: Stages of the HIV-1 life cycle that are targeted by antiretroviral drugs.
Figure 2: Semi-log and median effect dose–response curves.
Figure 3: Empirical in vitro analysis of pairwise interactions between antiretroviral drugs.

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Acknowledgements

This work was supported by the US National Institutes of Health (RO1 grant AI081600) and the Howard Hughes Medical Institute, USA.

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  1. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 21205, Maryland, USA

    Sarah B. Laskey & Robert F. Siliciano

  2. Howard Hughes Medical Institute, Baltimore, 21250, Maryland, USA

    Robert F. Siliciano

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Correspondence to Robert F. Siliciano.

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Laskey, S., Siliciano, R. A mechanistic theory to explain the efficacy of antiretroviral therapy. Nat Rev Microbiol 12, 772–780 (2014). https://doi.org/10.1038/nrmicro3351

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