Maturation Inhibitors

The theory behind HIV treatment is to use drugs that attack specific steps in the HIV life cycle. Protease inhibitors prevent the enzyme protease from cutting HIV into shorter pieces necessary for HIV replication. Fusion inhibitors prevent HIV from binding to CD4 cells. Different HIV drug classes inhibit or interfere with different steps in the HIV life cycle. Developers are now testing a new class of HIV medication; one that will attack a step in the life cycle not yet exploited by existing HIV medications. The new class, maturation inhibitors are moving closer to being a reality. Let's look at them a bit closer.

A Step-by-Step Pictorial Tour of the HIV Life Cycle

What is HIV Maturation?

Maturation is the last of 10 steps in HIV replication or the HIV life cycle. It is the step in which HIV "grows up" so to speak; taking those last developmental steps in order for HIV to become infectious.

What are Maturation Inhibitors?

Maturation Inhibitors aim to prevent HIV from properly assembling and maturing, from forming a protective outer coat, or from emerging from human cells. Inhibiting this step is an entirely new way to halt or inhibit HIV replication.

Why is a New Drug Class Significant?

HIV treatment regimens are comprised of drugs from different drug classes taken together in order to attack the HIV life cycle at different steps all at once. The more steps that can be interefered with the more effective viral suppression that can be achieved. In addition, HIV changes or mutates while being exposed to HIV drugs. Mutations can make HIV more difficult to treat and resistant to entire classes of HIV medicines. Introducing a new drug class will give those people who have exhausted all their treatment options a new class of drugs from which new effective regimens can be made.

What is HIV Resistance?

Are there Any Maturation Inhibitors on the Market Now?

Currently there are no FDA approved maturation inhibitors available. There is one maturation inhibitor in trials currently. PA-457 or Bevirimat as it has been named is from the drug manufacturer Panacos. Bevirimat has shown very promising results in early Phase I and Phase II trials, showing good antiviral activity even in patients with resistant virus. Additionally, a recent safety study showed that Bevirimat was safe to be taken with other established HIV medications. Specifically, when Berivimat was taken with Reyataz, bilirubin levels in the blood were not elevated anymore than with Reyataz alone. More extensive studies are needed before Berivimat is ready from commercial use but the promising data is cause for optimism.

10 Questions to Ask Before Entering a Drug Trial

Clinical Trial Facts and Guidelines

The drug development and approval process may seem slow but it is necessary in order to make sure the new drugs are safe and appropriate dosing is being prescribed. Luckily, we have several options for effective regimens to carry us through until new therapies are ready.

Integrase Inhibitors - Another New Drug Class

_{Source: DeJesus, Edwin; "HIV Antiretrovirals Agents in Development"; The Body; March 2006.}