As 2023 marks 40 years of the discovery of HIV, the American site Pos looks back at five decades of HIV treatment and highlights the phenomenal advances in treatment: from AZT to injectable treatments. The 1980s: It took six years following the first identified cases of AIDS patients (in 1981) for the FDA (the American drug agency) to approve the first antiretroviral drug, the nucleoside reverse transcriptase inhibitor Retrovir (AZT, or zidovudine) in 1987. The 1990s: The FDA instituted an expedited approval procedure for investigational drugs in 1992. Three other nucleoside reverse transcriptase inhibitors were approved in the early 1990s, but it was become clear that the use of drugs, one by one, leads to resistance. The FDA approved the first protease inhibitor, Invirase (saquinavir), in 1995, and the first nucleoside/nucleotide reverse transcriptase inhibitor (NNRTI), Viramune (nelfinavir), in 1996. These new molecules thus mark the beginning of the era of effective triple therapies. The 2000s: The first triple therapies once morest HIV were difficult to take, often with many tablets to swallow and serious adverse effects. In 2001, the FDA approved tenofovir (tenofovir disoproxil fumarate, or TDF), the first nucleotide reverse transcriptase inhibitor. The first single-pill treatment, Atripla (efavirenz/TDF/emtricitabine), was approved in 2006, allowing many people to take just one pill a day. Finally, in 2007, the FDA approved the first anti-integrase, Isentress (raltegravir). The 2010s: This decade is marked by the confirmation of the effectiveness of Tasp (undetectable HIV = intransmissible HIV or I = I). A revolution in the lives of people living with HIV. Another revolution, this time in prevention when, in July 2012, the FDA approved Truvada (TDF/emtricitabine) as a preventive treatment (Prep). The 2020s: In 2020, the FDA approves the first attachment inhibitor, Rukobia (fostemsavir). The following year, in 2021, the American agency approved the first long-acting injectable HIV treatment, Cabenuva, marketed in France under the name Vocabria/Rekambys (cabotegravir/rilpivirine). A few months later, the long-acting injectable Prep, Apretude (cabotegravir alone) is authorized in the United States. Finally, in December 2022, the American agency gave the green light to the marketing of the first HIV capsid inhibitor, Sunlenca (lenacapavir), an injection administered once every six months for people living with multidrug-resistant HIV.
NB: Apretude and Sunlenca are not yet marketed in France.
