The advances of anti2hiv drugs

Transcription

1 Chinese Journal of New Drugs 2002,Vol. 11 No toxicity in CEM cells treated with carbovir [J ]. A ntivi ral Res, 1997, [ 29 ] Parese2Di GA,Rouquayrol M, Greiner J, et al. Synthesis and an2 ti2hiv activity of prodrugs derived from saquinavir and indinavir [J ]. A ntivi r Chem Chemother,2000,11 (2) [ 30 ] Corbett AH, Rublein J C. DAPD ( Emory University/ Triangle Pharmaceutials/ Abbot Laboratories) [ J ]. Curr Opi n Investi ng Drugs,2001,2 (3) ( : ) (, ) [ ], tenofovir 2 trivizir ; efavirenz ; Kaletra [ ] ; ; [ ] R [ ] A [ ] (2002) The advances of anti2hiv drugs TAO PEI2zhen ( Instit ute of Medicinal B iotechnology, Chinese A cadem y of Medical Sciences and Peking U nion Medical College, Beijing , China) [ Abstract] The clinical medication and recent advances of anti2hiv drugs have been reviewed, which include NRTIs :AZT,ddI,ddC,d4 T,3 TC,abacavir,tenofovir,combivir and trivizir ; NNRTIs : nevirapine,delavirdine,efavirenz ; PIs :saquinavir,ritonavir,indinavir,nelfinavir,amprenavir,and kaletra. [ Key words] anti2viral drugs ;AIDS ; HIV 1981 (AIDS) 2 ( HIV), 3, , HIV 4 000, , AIDS, HIV, 24h HIV,, AIDS HIV 30 %, 20 90, [16, ] 1987, 18, FDA / VX2478), 3,, / (zidovudine,azt,zdv,retrovir, 03/ 1987 GlaxoSmith Kline ) (didanosine,ddi,videx, ) 10/ 1991 Bristol2Myers Squibb (zalcitabine,ddc,hivid) 06/ 1992 Hoffman2La Roche (stavudine,d4t,zerit, ) 06/ 1994 Bristol2Myers Squibb (lamivudine,3tc,epivir) 11/ 1995 GlaxoSmith Kline (saquinavir, Invirase, INV,) 12/ 1995 Hoffman2La Roche (ritonavir,norvir,rtv) 03/ 1996 Abbott Laboratories (indinavir,crixivan) 03/ 1996 Merck (nevirapine,viramune, ) 06/ 1996 Boehringer Ingelheim/ Roxane (nelfinavir,viracept, ) 03/ 1997 Agouron Pharmaceuticals (delavirdine,dlv,rescriptor) 04/ 1997 Pfizer (Agouron Unit) Combivir(AZT + 3 TC, ) 09/ 1997 GlaxoSmith Kline Efavirenz(DMD2266,EFV,Sustiva, ) 09/ 1998 Dupont2Merck (abacavir,1582u89,ziagen,abc) 12/ 1998 GlaxoSmith Kline (amprenavir,agenerase,141w 04/ 1999 GlaxoSmith Kline Kaletra(lopinavir(ABT378) & ritonavir(4 1) 09/ 2000 Abbott Laboratories Trivizir (AZT + 3TC + abacavir) 11/ 2000 GlaxoSmith Kline tenofovir disoproxil fumarate (tenofovir DF, 10/ 2001 Gilead Sciences INV,Viread)

2 Chinese Journal of New Drugs 2002,Vol. 11 No ( NRTIs) NRTIs 9, ABC, 1 AZT,ddI,ddC,d4T,3TC,abacavir,tenofovir combivir (AZT + 3TC) trivizir (AZT + 3TC + 1 NRTIs NNRTIs NRTIs DNA, DNA ; 3, 1 AZT d4 T, DNA 3, ddc 3 TC, ddi tenofovir,abc,, HIV,, HIV21 RT DNA HIV21 ( RT), HIV21 RT, RT, IC 50 /mol L , DNA 2 NRTIs / % C max /mol L - 1 t 1/ 2 / h (, ) / % / , ,2540 < ,3. 0 < , ,12 < , tenofovir disoproxil ( ), ng ml - 1 fumarate 1215 ( ) ; 3439 ( ) 3035 ( ) AZT d4 T HIV21 ;ABC,,ddI,ddC,3 TC, ; 3 TC tenofovir HIV21, 2, qd,, 2 ( NNRTIs) AZT ( NNRTIs 3, ) ; ddi ddc efavirenz, HIV21 843

3 Chinese Journal of New Drugs 2002,Vol. 11 No , HIV22 ( SIV),,, 1 NRTIs,, NNRTIs,, HIV21,efavirenz DNA, RT P66, NRTIs,,, 3 HIV21 RT, DNA IC 50 /mol L NNRTIs / % C max /mol L - 1 t 1/ 2 / h / % / > efavirenz ( IC 95 ) 42 () ( protease inhibitors, PIs) PIs 6, Kaletra, 2 HIV21 HIV21 pol,99 2 PIs (, HIV21 ), ( ), gag pol,, > 2L d - 1, Kalet ra, (lopinavir ), lopinavir PIs HIV,, 10, 1995 PI, 3 2, lopinavir PIs PIs NRTIs,, HIV21,, 4 844

4 Chinese Journal of New Drugs 2002,Vol. 11 No PIs IC 50 /mol L - 1 / %, / % C max /mol L - 1 t 1/ 2 / h / % , < > ( IC 95 ) 60, , ( IC 95 ) 43, < > > 70, < Kaletra(lopinavir & ) (IC 50 lopinavir) 9. 6 mg L HAART ( Highly Active Anti2Retroviral Ther2 apy) 1987 scheduled anti2retroviral therapy interruption),, HAART PIs,, HAART 1,1996 HAART 3, HAART / 100 HAART, CD 4 < 350 ml - 1 HIV2RNA > ml - 1 ( RT2PCR ) HIV2RNA > , HAART ml - 1 (bdna ) ( PCP) 4. 9/ 100 (95 % ), HAART 0. 3/ 100 (95 %, 00. 9), 1/ AIDS,,: STI ( structured or,, 13, 1 PI 2,, CTL + AZT + 3 TC ; + AZT + 3 TC ; 2 1, AZT + 3 TC ;efavirenz + ;STI 1/ 21/ AZT + 3 TC 2001, ddi +, (DHHS) HIV ddi,, 1/ 2 ( IL22, HE2000 HIV, A,B, ),MASC (M :,A A :efavirenz,,, +,S :,C :),, + lopinavir, + [6 B :d4 T + ddi, d4 T + 3 TC,AZT + ddi,azt + 3 TC 4. 2 ] HAART 23,, ( < 50 ml - 1 ) 1996 HIV,,, (CDC), 2001 DHHS 1/ 3, 1/ 4, 10 8 CD 4 < 500 ml , / HIV2RNA > ml - 1 ( RT2PCR ), HIV, [7 HAART, AIDS 4. 3 ] AIDS, 3,,, NNRTIs, 8,, HIV,100 %, PIs,,, NRTIs,, ;,, ;,, 845

5 Chinese Journal of New Drugs 2002,Vol. 11 No HAART AIDS,,,, [ HIV,9] HIV : (010) %50 %, AZT [ 66 %, ] [1 ]. [ M ]. :, HIV, 4. 5, AZT + 3 TC, HIV % HIV 72h HIV, 28d, 6,1 4. 6, I, II, 229., 2 :, ;, SH 4. 7 NRTIs : [10 ] emtricitabine ( Coviracil, FTC ; Triangle) NNRTIs : emivirine ( Coactinon, M KC ; Triangle Pharma2 ceuticals), capravirine [ A G1549, Pfizer ( Agouron U2 nit) ]PIs : BMS ( Bristol2Myers Squibb ), GW433908/ V X2175 ( GlaxoSmit h Kline ), t ripanavir (PNU ;Boehringer) HIV : T220 ( Trimeris2Hoffmann La Roche) AIDS,, [ ] ( ),, : 610. [2 ]. [ M ]. :, [3 ] De Clercq E. Antiviral drugs :current state of art [J ]. J Cli n V i2 rol,2001,22 (1) [ 4 ] Smith PF,DiCenzo R, Morse GD. Clinical pharmacokinetics of non2nucleoside reverse transcriptase inhibitors[j ]. Clin Pharma2 coki net,2001,40 (12) [5 ] Harris M,Montaner J SG. Clinical uses of non2nucleoside reverse transcriptase inhibitors [ J ]. Rev Med V i rol, 2000, [6 ],. HIV/ AIDS [ A ]. ( ). [ C]. :, [ 7 ] Telenti A,Paolo RG. Limits to potent antiretroviral therapy[j ]. Rev Med V i rol,2000, [ 8 ],,. HIV21 [J ].,2001,7 (5) [9 ],,,. 21 [ A ]. ( ), [ C]. :, [ 10 ] De Clercq E. New developments in anti2hiv chemotherapy[j ]. Cur Med Chem,2001,8 (13) ( : ), 16,64 : ISSN X, :CN / R, :22-26, (), 8. 00, : 162, :030002, ( ) : (0351) ,E2mail ty. sx. cn 12, 300 / / 2003, ( ) 1000 () ( ) () ( ),, () 380 /, () 260 / : 38, :100810, : (010) , : (010) :, :, :