- Chronic oral HIV treatment is associated with significant complications due to heavy pill burden, resulting in poor patient compliance
- Conventional HIV medicines for pediatric patients are not widely available
- Nanotherapy approach to HIV treatments hopes to overcome these problems
- In addition, reduced healthcare costs using nanotherapy would enable treatment of more patients with prevailing healthcare budgets.
Nanomedicine technology could enhance the administration and availability of drug treatment for HIV, according to new research conducted by the University of Liverpool.
Aim of the Research
‘Nanotherapy for HIV might improve patient compliance by reducing drug dosage and minimizing complications.’
Status of Currently Available HIV Treatment Options
At present, therapy for HIV necessitates daily oral dosing of anti-HIV drugs. Such chronic oral dosing comes with noticeable complications due to the heavy dosage being taken by many patients worldwide, with various other chronic conditions leading in many instances to non-compliance to therapies.
Currently, there are no clinically available oral nanotherapy options for HIV populations in general and conventional pediatric HIV medicines are not readily available.
In fact, the researchers noticed that one currently available pediatric HIV drug formulation employed high concentrations of ethanol as a solvent for lopinavir, an anti-retroviral drug that is poorly soluble.
What Nanotherapy for HIV Hopes to Achieve
Researchers at the Liverpool University have focused their attention on the development of novel oral drug treatment for HIV, using Solid Drug Nanoparticle (SDN) technology that could enhance drug absorption into the body, and thus decreasing both the dose and the cost per dose for the patient. This they feel would improve patient compliance and also enable existing healthcare budgets to treat more patients.
Additionally, using a rapid small-scale nanomedicine screening technology developed at Liverpool, the research team was able to generate a novel water dispersible nanotherapy, that eliminated the need to use alcohol in the pediatric medicine.
Complications of Anti-retroviral Therapy (ART)
Anti-retroviral therapy is associated with numerous complications that are influenced by intake of other drugs by the patient, and other underlying conditions in the patient such as hepatitis and tuberculosis.
The common adverse effects of ART include
- Bleeding events
- Loss of bone density
- Bone marrow suppression
- Increased risk of heart attacks
- Insulin resistance and Diabetes mellitus
- Altered lipid metabolism (dyslipidemia)
- Nausea and vomiting
- Fatty change in liver
- Hypersensitivity reactions
- Lactic acidosis
- Altered body fat distribution
- Myopathy (muscle involvement)
- Peripheral neuropathy
- Renal stones
- Stevens - Johnson syndrome
Toxicities are managed by modifying dosage or switching over to an alternative drug or regimen. The patient's viral load needs to be monitored at regular intervals to ensure continued viral suppression. In spite of such interventions, the drug compliance may be poor in some patients.
Nanotechnology involves the manipulation of matter at the level of atoms, molecular and molecular fragments. According to one definition, nanotechnology is the manipulation of matter with at least one dimension sized from 1 to 100 nanometers. Nanotechnology may be employed to generate many new materials and devices with a host of applications, including the field of medicine (nanomedicine).
The use of nanotechnology as an approach for delivery of drugs is revolutionizing medical treatment in several fields of medicine. Cancer chemotherapy has seen the biggest impact so far, with significant advances in the last few decades.
This phenomenal success and increasing popularity can be attributed mainly to the singular features that nanotechnology imparts to drug delivery systems Using nanotechnology, it has now become possible to
- Obtain better delivery of poorly water-soluble drugs,
- Target drug delivery to specific cells or tissues and
- Intracellular delivery of macromolecules.
Role of Nanotherapy in HIV Treatment
Nanotherapy-based methods for systemic delivery of antiretroviral drugs could benefit from the same advantages listed above.
Controlled-release delivery systems can improve the half-lives of drugs, and keep them in circulation at therapeutic concentrations for longer durations. This could go a long way in the improvement of drug compliance.
Targeted nanoparticles employing molecules such as mannose, galactose, and tuftsin have been used to target macrophages, which are the major reservoirs of the virus. Additionally, targeted co-delivery of two or more antiviral drugs in a nanoparticle based system could also markedly improve management of viral reservoirs
Nanoscale delivery systems also improve and fine-tune the distribution of hydrophobic and hydrophilic drugs into and within various tissues due to their miniscule dimensions. This particular aspect of nanoscale drug delivery systems seems to hold a lot of promise, prompting a lot of research exploring its application in the treatment and prevention of HIV.
- Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents - (https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/31/adverse-effects-of-arv)
- Emerging nanotechnology approaches for HIV/AIDS treatment and prevention - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861897/)
- Nanotechnology - (https://en.wikipedia.org/wiki/Nanotechnology)
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