HIV

Acquired Immunodeficiency Syndrome (AIDS) is a clinical infirmity that is a result of infection with Human immunodeficiency virus (HIV), which causes intense immunosuppression. Many compounds of plant origin that inhibit HIV during various stages of cycle theses include several alkaloids, Carbohydrates, Xanthenes and tannins. These compounds have the capability to come up as a medication for therapy of HIV infection. Herbal medication provides rational means for the therapy of Aids, the Herbal drugs which are utilized in Nut, Turmeric, Asoka, Sarpagandha, Cotton Seed, Arjuna. So, the focus of this review article is to pinpoint possessing activity against HIV objective of providing an effective approach for prevention of transmission and therapy of these diseases.

Etravirine is a non-neucleoside reverse transcriptase inhibitor (NNRTI) used in the treatment of HIV. One of the major problems with the Etravirine is its low solubility, which results into poor bioavailability after oral administration. Therefore, solid dispersions (SDs) of Etravirine were prepared by two methods, Hot-melt extrusion and Spray drying technique using various carriers like Polyvinyl Caprolactam-Polyvinyl Acetate-Polyethylene Glycol Graft Copolymer (Soluplus), Hypromellose 2.5 cPs, PEG 6000, Amino Methacrylate Copolymer (Eudragit EPO) & Copovidone (Kollidon VA64) and Povidone (Kollidon 30) to increase its aqueous solubility. Faster and high drug release was found in the SDs prepared by hot melt extrusion (HME) with soluplus in the ratio of 1:3 as compared with spray drying technique (SDT) using drug substance, Soluplus and Microcrystalline cellulose (Avicel PH105) in the ratio of 1:2:0.5. There is 3 fold increases in the solubility of Etravirine prepared by HME & SDT compared with pure drug substance. HM3 and SDT4 are finalized as optimized formulations prepared by HME & SDT based on their solubility, drug substance content and in vitro drug dissolution studies. FT-IR, DSC and XRD of SDs by HME & SDT showed a change in crystal structure toward an amorphous form of Etravirine. The obtained results suggested that developed Etravirine SDs by HME & SDT has potential for oral delivery and might be an efficacious approach for enhancing the therapeutic potential of Etravirine.

The advent of highly active antiretroviral (ARV) agents has led to striking reduction in plasma viral load, opportunistic infection and mortality from AIDS. Unfortunately most of these drugs have poor physiochemical, metabolism or transport properties that result in poor or variable absorption and side effects, which are often related to the accumulation of the drug at inappropriate sites. Various classes of antiretroviral agents are available, though monotherapy in HIV positive individuals can develop resistance more quickly as compared to combinational therapy or fixed dose combination or highly active antiretroviral therapy. The currently available ARV drugs mostly oral formulations, which are associated with several disadvantages and inconveniences to the HIV patients. The delivery of drugs via oral route suffers from significant first-pass effect, variation of absorption and degradation in the gastrointestinal, erratic bioavailability, limited duration of drug action, metabolism/elimination and transport barriers reducing the effect of anti-HIV drugs reaching the target site. Also half-life of several ARV drugs is short, which requires frequent administration of doses leads to poor patient compliance. Therefore, the usage of novel drug delivery systems is a logical approach to circumvent these problems and effectively treat the HIV infection. Various novel drug delivery techniques were tried or on trial for ARV drugs. Among the recent approaches of novel drug delivery system for anti-HIV drugs, controlled/sustained and targeted/intracellular drug delivery are the important ones. In this review the need for novel drug delivery, advantages, and recent development in drug delivery system of antiretroviral drugs were discussed, which may useful for further research in future.