Novel Approaches for Delivery of Anti-HIV Drugs

Dear Colleagues,

HIV/AIDS continues to be one of the most challenging individual and public health concerns of our days, affecting roughly 37 million individuals worldwide and killing nearly two million people each year according to the UNAIDS (The Joint United Nations Programme on HIV/AIDS). Investments in the field have been huge but a cure to the infection remains elusive. Nonetheless, tremendous advances have been made over the last 35 years since the HIV-1 was identified, namely in prevention, diagnostics and treatment. The development of antiretroviral drugs and the introduction of highly active antiretroviral therapy (HAART) in the mid-1990s—currently referred to as combination antiretroviral therapy (cART)—led to a dramatic shift of AIDS from a fatal disease into a chronic and often stable medical condition. In fact, cART contributed decisively to a steady decrease in the number of HIV-related deaths since the first years of the new millennium. Antiretroviral drugs have also been found useful in the prevention field, particularly in post-exposure prophylaxis (PEP) or mother-to-child transmission. Treatment as prevention and pre-exposure prophylaxis (PrEP) have further contributed to the reduction of sexually-transmitted HIV infections. Long-lasting injectable products and antiretroviral-based microbicides that are currently in late stages of clinical development or regulatory approval may soon provide new options for prevention. Gene therapy and the use of broadly neutralizing antibodies is also attracting a great deal of interest as possible approaches to HIV/AIDS management.

Still, many challenges remain in anti-HIV drug therapy/prophylaxis and these include, among others: (i) the onset of severe adverse effects leading to discontinuation or interruption of therapy/prophylaxis; (ii) sub-optimal biodistribution and pharmacokinetics, particularly at reservoir sites or mucosae involved in sexual transmission; (iii) the occurrence of viral resistance; (iv) troublesome regimens and/or drug delivery routes that lead to poor adherence by patients/users; (v) low stability and reduced shelf-life of active molecules, which may be particularly challenging in tropical climates and low-resource regions lacking adequate refrigerated distribution channels and storage; (vi) lack of adequate dosage forms for particular populations (e.g. children, women); (vii) costly drug products that are often inaccessible to populations in need of therapy/prophylaxis; and (viii) social and legal constraints resulting in poor access to and discontinuation of anti-HIV therapy/prophylaxis.

This Special Issue of Pharmaceutics intends to focus on new strategies and approaches to the formulation and delivery of anti-HIV drugs (including genetic material and other biopharmaceuticals), which could help solving many of the above identified issues. We welcome articles on all aspects of anti-HIV drug delivery intended at advancing therapy or prophylaxis of HIV/AIDS.

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• Acquired Immunodeficiency Syndrome (AIDS)
• Anti-HIV Agents
• Antiretroviral Drug Delivery
• Broadly Neutralizing Antibodies
• Combination Antiretroviral Therapy (cART)
• Combination Products
• Gene Therapy
• Human Immunodeficiency Virus (HIV)
• Long Acting Injectables
• Microbicide Vaginal Rings
• Mother-To-Child Transmission
• Multipurpose Prevention Technologies
• Nanomedicines
• NeuroAIDS
• Pharmacokinetics
• Post-Exposure Prophylaxis (PEP)
• Pre-Exposure Prophylaxis (PrEP)
• Rectal Microbicides
• Reservoir Sites
• Vaginal Microbicides