Medicinal Chemistry of Anti-HIV-1 Latency Chemotherapeutics: Biotargets, Binding Modes and Structure-Activity Relationship Investigation

Molecules. 2022 Dec 20;28(1):3. doi: 10.3390/molecules28010003.

Abstract

The existence of latent viral reservoirs (LVRs), also called latent cells, has long been an acknowledged stubborn hurdle for effective treatment of HIV-1/AIDS. This stable and heterogeneous reservoir, which mainly exists in resting memory CD4+ T cells, is not only resistant to highly active antiretroviral therapy (HAART) but cannot be detected by the immune system, leading to rapid drug resistance and viral rebound once antiviral treatment is interrupted. Accordingly, various functional cure strategies have been proposed to combat this barrier, among which one of the widely accepted and utilized protocols is the so-called 'shock-and-kill' regimen. The protocol begins with latency-reversing agents (LRAs), either alone or in combination, to reactivate the latent HIV-1 proviruses, then eliminates them by viral cytopathic mechanisms (e.g., currently available antiviral drugs) or by the immune killing function of the immune system (e.g., NK and CD8+ T cells). In this review, we focuse on the currently explored small molecular LRAs, with emphasis on their mechanism-directed drug targets, binding modes and structure-relationship activity (SAR) profiles, aiming to provide safer and more effective remedies for treating HIV-1 infection.

Keywords: HIV-1; anti-HIV-1-latency; latency-reversing agents (LRAs); latent reservoirs (LVRs); resting CD4+ T cells (rCD4s).

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents* / chemistry
  • Anti-HIV Agents* / pharmacology
  • Anti-HIV Agents* / therapeutic use
  • CD4-Positive T-Lymphocytes
  • Chemistry, Pharmaceutical
  • HIV Infections* / drug therapy
  • HIV-1* / drug effects
  • Humans
  • Structure-Activity Relationship
  • Virus Activation
  • Virus Latency* / drug effects

Substances

  • Anti-HIV Agents