Antiviral Therapy and Emerging Treatment Strategies in Human Immunodeficiency Virus (HIV): A Comprehensive Review

Human Immunodeficiency Virus (HIV) infection remains a major global health concern despite decades of research and therapeutic advancements. HIV primarily targets CD4+ T lymphocytes, macrophages, and dendritic cells, leading to progressive immune suppression and increased susceptibility to opportunistic infections and malignancies 1,2. The advent of antiretroviral therapy (ART) has dramatically improved survival and quality of life, transforming HIV infection from a fatal disease into a manageable chronic condition 3. Antiviral therapy for HIV is based on combination regimens targeting multiple stages of the viral life cycle, including viral entry, reverse transcription, integration, and maturation 4. Highly Active Antiretroviral Therapy (HAART) has become the cornerstone of HIV management, significantly reducing viral load, restoring immune function, and preventing disease progression 5. Current treatment guidelines recommend early initiation of ART irrespective of CD4 count, which has been shown to reduce transmission and improve long-term outcomes 6. Emerging therapeutic strategies such as long-acting injectable antiretrovirals, broadly neutralizing antibodies, gene-editing technologies, and therapeutic vaccines hold promise for improving adherence and potentially achieving functional cure 7,8. However, challenges including drug resistance, toxicity, adherence issues, and limited access in resource-poor settings continue to hinder effective HIV control 9. This review provides a comprehensive and detailed overview of antiviral therapy and various treatment strategies in HIV, including mechanisms of action, clinical applications, challenges, and future directions.