An antiretroviral medication class called HIV protease inhibitors (PIs) is used to treat HIV/AIDS. They go after the HIV protease enzyme, which is essential to the HIV virus's ability to replicate. Protease inhibitors essentially stop the development of new viral particles by inhibiting this enzyme, which slows down the disease's course. Large viral precursor proteins are broken down into smaller, functional proteins by the enzyme HIV protease, which is necessary for the formation of fresh HIV particles that are infectious. The HIV replication cycle depends on this pathway. In the absence of functional protease, the virus cannot develop into contagious. HIV protease inhibitors function by attaching themselves to the protease enzyme's active site and stopping it from correctly cleaving the precursor proteins. This prevents the virus from spreading throughout the body by producing immature and non-infectious viral particles. In the mid-1990s, the discovery of HIV protease inhibitors transformed the treatment of HIV/AIDS and represented a major breakthrough in antiretroviral therapy. Known as highly active antiretroviral therapy (HAART) or combination antiretroviral therapy (cART), protease inhibitors are frequently used in conjunction with other antiretroviral medications. The prognosis for people with HIV/AIDS has significantly improved because to this strategy, which has also decreased mortality rates and raised quality of life. Saquinavir, ritonavir, indinavir, nelfinavir, amprenavir, lopinavir, atazanavir, darunavir, and tipranavir are among the HIV protease inhibitors that have received FDA approval. Every inhibitor has a different pharmacokinetic profile, dosage needs, and possible adverse effects. For instance, ritanavir is frequently used as a "booster" medication because of its capacity to inhibit cytochrome P450 enzymes, which, when co-administered with other protease inhibitors, can raise plasma concentration and extend their half-life. HIV protease inhibitors have been crucial in the fight against HIV/AIDS, but they are not without drawbacks. Common side effects include gastrointestinal symptoms, medication interactions, and metabolic abnormalities (dyslipidemia, insulin resistance, etc.). Furthermore, the appearance Developing drug-resistant HIV strains continues to be a major obstacle to long-term care. Mutations in the viral protease gene have the potential to cause resistance, which can result in decreased therapeutic efficacy and treatment failure. Combination therapy, which uses many medications that target several stages of the virus replication cycle, is crucial to combating this. HIV protease inhibitors remain a vital component of HIV/AIDS treatment despite these difficulties. The goal of ongoing research is to create novel protease inhibitors with enhanced resistance profiles, tolerability, and efficacy. To improve patient adherence and outcomes, efforts are also being made to investigate new drug delivery methods and optimize treatment plans. The prognosis for people living with HIV/AIDS is improving due to ongoing developments in antiretroviral medication, which gives promise for improved disease management in the future.
