Modern approaches in nanomedicine for NeuroAIDS and CNS drug delivery

Abstract

NeuroAIDS is a neuropsychiatric disorder primarily caused by chronic human immunodeficiency virus (HIV). The most common neurological complications during NeuroAIDS are HAD (HIV-associated dementia) and HAND (HIV-associated neurocognitive disorder). HAART (highly active antiretroviral therapy) is a group of ARV (antiretroviral) drugs used to inhibit the key proteins involved in HIV replication. ARV drugs are extensively used to decrease the viral load and risk of opportunistic infections and to prolong survival of HIV-infected individuals. Significant advancement in antiretroviral (ARV) drugs has been achieved. However, the elimination of HIV from the CNS remains a difficult task. The complex structure of blood-brain barrier (BBB), high plasma protein binding, low patient compliance, and poor pharmacokinetics and biodistribution are the major limitations which restrict the effective concentration of drug to the CNS resulting in low efficacy of HAART in the CNS. Development of novel nanotechnology-based drug delivery methods for ARV drugs can increase the effectiveness of regimen with fewer side effects and better patient compliance which reduces financial load of healthcare system. The present article discusses about the nanotechnology-based approaches that can improve the delivery of ARV, called nano-ART. Nano-ART has excellent BBB permeability and improved pharmacokinetics and biodistribution that have significant clinical advantages to cure the CNS infection of HIV.