AbstractTreatment and prevention of human immunodeficiency virus type one (HIV-1) infection was transformed through widespread use of antiretroviral therapy (ART). However, ART has limitations in requiring life-long daily adherence. Such limitations have led to the creation of long-acting (LA) ART. While nucleoside reverse transcriptase inhibitors (NRTI) remain the ART backbone, to the best of our knowledge, none have been converted into LA agents. To these ends, we transformed tenofovir (TFV) into LA surfactant stabilized aqueous prodrug nanocrystals (referred to as NM1TFV and NM2TFV), enhancing intracellular drug uptake and retention. A single intramuscular injection of NM1TFV, NM2TFV, or a nanoformulated tenofovir alafenamide (NTAF) at 75 mg/kg TFV equivalents to Sprague Dawley rats sustains active TFV-diphosphate (TFV-DP) levels ≥ four times the 90% effective dose for two months. NM1TFV, NM2TFV and NTAF elicit TFV-DP levels of 11,276, 1,651, and 397 fmol/g in rectal tissue, respectively. These results are a significant step towards a LA TFV ProTide.
治疗和预防人类免疫缺陷病毒类型一(HIV-1)感染已通过广泛使用抗逆转录病毒疗法(ART)而得以转变。然而,ART在需要终身每日依从方面存在局限性。这些限制导致了长效(LA)ART的产生。尽管核苷类逆转录酶抑制剂(NRTI)仍然是ART的基础,据我们所知,尚未将任何NRTI转化为长效药物。为此,我们将替诺福韦(TFV)转化为长效表面活性剂稳定的水性前药纳米晶体(称为NM1TFV和NM2TFV),增强细胞内药物摄取和保留。将NM1TFV、NM2TFV或纳米制剂替诺福韦阿拉芬胺(NTAF)以每千克75毫克TFV当量剂量注射到斯普拉格-道利大鼠体内,可维持活性TFV-二磷酸(TFV-DP)水平≥90%有效剂量的四倍以上,持续两个月。NM1TFV、NM2TFV和NTAF在直肠组织中分别引起11,276、1,651和397 fmol/g的TFV-DP水平。这些结果是朝着长效TFV ProTide迈出的重要一步。