Current status of dolutegravir delivery systems for the treatment of HIV-1 infection

Abstract

According to the World Health Organization (WHO), an estimated 37.7 million people were living with HIV in 2020. Dolutegravir is recommended as the first line and second line antiretroviral drug for the treatment of HIV-1 infection in combination with NRTI and NNRTI in all populations. It is the second-generation integrase strand transfer inhibitor which is preferred over elvitegravir and raltegravir because of enhanced elimination half-life, reduced dosing frequency, and higher barrier to resistance. Dolutegravir is available in the market in the form of oral tablet for the treatment of HIV-1 infection in all populations. Several other formulations including long-acting gastroretentive dosage form, long-acting injectables, in-situ forming implants, nasal, and vaginal formulations have also been reported which have shown promising results in the treatment of HIV-1 infection in preclinical studies. In the future, clinical translation of the long-acting formulations will enhance the adherence to the therapy by the patient and bring us closer to the goal of eradicating HIV as an epidemic by 2030. The present review elaborates on different strategies which have been reported for the delivery of dolutegravir in adults and paediatrics.