Since the development in 1996 of the first triple therapies, treatments against the human immunodeficiency virus (HIV) have continued to be improved, to achieve optimal efficiency combined with a reduction in adverse effects. A new step in this development, aimed especially at the quality of life of the patient, has just been taken with the reimbursement since December 21, 2021 of an injectable formula of two antiretrovirals marketed by the laboratory ViiV Healthcare, after its authorization by the European Medicines Agency in December 2020.
Administered every two months, it offers infected people the possibility of freeing themselves from the daily intake of tablets, which is sometimes felt to be stigmatizing. “This injectable treatment ushers in a new era in HIV treatment, based on the principle of long-term treatment. The main advantage is that people no longer have to take a pill every day ”, says infectious disease specialist Yazdan Yazdanpanah, director of the National Agency for Research Against AIDS, Hepatitis and Emerging Diseases (ANRS / Emerging Diseases).
“We have gone from very heavy antiretroviral treatments comprising several tablets two to three times a day, with dietary constraints and long-term toxic effects, to combinations of treatments limited to one tablet per day in a single dose, more and more. more powerful and better and better tolerated, summarizes the infectious disease specialist Laurence Slama, from the Hôtel-Dieu hospital in Paris. We are now witnessing a new phase characterized by a diversification of less toxic and simpler antiretroviral treatments. “
Increased efficiency
“The more treatments, the better, because patients do not have the same needs depending on whether they are a sex worker, an elderly person or an adolescent, but there is it remains to be seen who will prefer this treatment over tablets, nuance the sociologist Bruno Spire of Inserm, who was director of the Aides association from 2007 to 2015. It can be of interest to those who find it difficult to come to terms with their HIV status or for young people, who are often less adherent to treatment than older people. “
HIV drugs fall into different categories based on the viral enzymes they inhibit. But as for the SARS-CoV-2 virus, HIV mutates, escaping the pressures exerted in particular by treatments, according to the evolutionary mechanism described by Charles Darwin, which explains the emergence of variants resistant to antiretrovirals. Hence the interest of the initial triple therapies allowing doctors to combine these antiretrovirals, so as to effectively control the replication of the virus. Over the course of the improvements made to them, these drugs have become more and more effective, making it possible to reduce the number of them in therapeutic combinations.
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