Antiretroviral Treatment of HIV-2 Infection: Available Drugs, Resistance Pathways, and Promising New Compounds

Inês Moranguinho, Nuno Taveira, Inês Bártolo

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)

Abstract

Currently, it is estimated that 1–2 million people worldwide are infected with HIV-2, accounting for 3–5% of the global burden of HIV. The course of HIV-2 infection is longer compared to HIV-1 infection, but without effective antiretroviral therapy (ART), a substantial proportion of infected patients will progress to AIDS and die. Antiretroviral drugs in clinical use were designed for HIV-1 and, unfortunately, some do not work as well, or do not work at all, for HIV-2. This is the case for non-nucleoside reverse transcriptase inhibitors (NNRTIs), the fusion inhibitor enfuvirtide (T-20), most protease inhibitors (PIs), the attachment inhibitor fostemsavir and most broadly neutralizing antibodies. Integrase inhibitors work well against HIV-2 and are included in first-line therapeutic regimens for HIV-2-infected patients. However, rapid emergence of drug resistance and cross-resistance within each drug class dramatically reduces second-line treatment options. New drugs are needed to treat infection with drug-resistant isolates. Here, we review the therapeutic armamentarium available to treat HIV-2-infected patients, as well as promising drugs in development. We also review HIV-2 drug resistance mutations and resistance pathways that develop in HIV-2-infected patients under treatment.

Original languageEnglish
Article number5905
JournalInternational Journal of Molecular Sciences
Volume24
Issue number6
DOIs
Publication statusPublished - Mar 2023

Keywords

  • HIV-2
  • HIV-2 treatment
  • antiretroviral drugs
  • resistance mutations
  • resistance pathways
  • Antiretroviral Therapy, Highly Active/adverse effects
  • Humans
  • Drug Resistance, Viral
  • Reverse Transcriptase Inhibitors/pharmacology
  • HIV Infections/drug therapy
  • Anti-HIV Agents/pharmacology

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