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.