Revolutionizing pediatric HIV therapy: The latest breakthroughs in drug delivery techniques

Human Immunodeficiency Virus (HIV) is the root cause of AIDS. It works by destroying immune system cells and rendering the body unable to fight infections and certain cancers. It is an STD in adults but in children, it is passed on from an HIV-positive mother in the womb or birth canal or while breastfeeding – this is called perinatal or vertical transmission of HIV [1,2]. Fig. 1 represents the factors influencing the vertical transmission of HIV [3]. While the number of children born with HIV has significantly reduced due to early diagnosis and treatment of the mother, the prevalence of the disease is still a concern [1,2].

HIV has been classified into 2 types based on different viral antigens and genetic characteristics. HIV 1 and 2 are morphologically similar, but HIV 1 has a virus protein unique as a regulatory protein wild HIV 2 has virus protein r which creates a difference in their pathogenicity- HIV 2 is less pathogenic to humans than HIV 1. Also, HIV 1 is the more commonly occurring form around the globe whereas HIV 2 is only found in certain West African countries [4,5].

In children, the immune system is not completely developed, so if they are HIV positive their chances of getting severely sick are way higher than in adults. Even if they catch a disease like an ear infection, diarrhea, or intestinal infection which are common in pediatrics, their body will not be able to fight the infection effectively [6]. In infants, symptoms, like delayed developmental growth, swollen abdomen and lymph nodes, pneumonia, and oral thrush, can be seen while children above 1 year of age can get a variety of infections which can be mild or severe [1].

Many antiretroviral drugs (ARVs) are available in the market for treating HIV in children, but the treatment regimen is of long duration and requires drug administration multiple times daily which makes it less compliant for the children as well as their parents and as a result, the children are unable to complete the regimen. Multiple new dosage forms such as microarray patches, buccal films, 3D-printed mini tablets, and food-based nanoparticles have been developed to overcome these problems. The goal of this article is to discuss the recent advances that have been made in HIV therapy for children along with the various clinical trials that are currently underway.