HIV Protease Inhibitors: Effect on the Opportunistic Protozoan Parasites

Abstract

The impact of highly active antiretroviral therapy (HAART) in the natural history of AIDS disease has been allowed to prolong the survival of people with HIV infection, particularly whose with increased HIV viral load. Additionally, the antiretroviral therapy could exert a certain degree of protection against parasitic diseases. A number of studies have been evidenced a decrease in the incidence of opportunistic parasitic infections in the era of HAART. Although these changes have been attributed to the restoration of cell-mediated immunity, induced by either non-nucleoside reverse transcriptase inhibitors or HIV protease inhibitors, in combination with at least two nucleoside reverse transcriptase inhibitors included in HAART, there are evidence that the control of these parasitic infections in HIV-positive persons under HAART, is also induced by the inhibition of the proteases of the parasites. This review focuses on the principal available data related with therapeutic HIV-protease inhibitors and their in vitro and in vivo effects on the opportunistic protozoan parasites.

Keywords: Protease inhibitors; antiretrovirals; parasite; protozoa; therapeutic agents.

Fig. (1)

Chemical structure of HIV-1 protease inhibitors. 1: Saquinavir; 2: Ritonavir; 3: Indinavir; 4: Nelfinavir; 5: Amprenavir; 6: Lopinavir; 7: Fosamprenavir; 8: Atazanavir; 9: Tipranavir; 10: Darunavir.

Fig. (2)

Mimetic action of hydroxyethylene bond from active group of peptidic protease inhibitor with normal peptide linkage cleaved by the human immunodeficiency virus protease.

Fig. (3)

Number of articles about antiprotozoal activity of HIV-protease inhibitors by year (N = 26).