Pharmacological intervention of HIV-1 maturation

摘要

Despite significant advances in antiretroviral therapy,increasing drug resistance and toxicities observed among many of the current approved human immunodeficiency virus(HIV) drugs indicate a need for discovery and development of potent and safe antivirals with a novel mechanism of action.Maturation inhibitors(MIs) represent one such new class of HIV therapies.MIs inhibit a late step in the HIV-1 Gag processing cascade,causing defective core condensation and the release of non-infectious virus particles from infected cells,thus blocking the spread of the infection to new cells.Clinical proof-ofconcept for the MIs was established with betulinic acid derived bevirimat,the prototype HIV-1 MI.Despite the discontinuation of its further clinical development in 2010 due to a lack of uniform patient response caused by naturally occurring drug resistance Gag polymorphisms,several second-generation MIs with improved activity against viruses exhibiting Gag polymorphism mediated resistance have been recently discovered and are under clinical evaluation in HIV/AID patients.In this review,current understanding of HIV-1 MIs is described and recent progress made toward elucidating the mechanism of action,target identification and development of second-generation MIs is reviewed.