A dose a day? Or just once a week? Spiky nanoparticles could simplify HIV medication routines

The emergence of antiretroviral treatments has made HIV - a disease once considered fatal - now altogether manageable.

But that success relies heavily on a patient sticking to their medication regime, taking the right dose at the right time, in many cases multiple pills every day.

This can make patient adherence rather challenging, with even slight changes to the regime giving the virus a chance to breathe and bounce back.

So we’ve got great drugs to control HIV, but how do we maximise their use to help the patients?

Thankfully, Dr Hao Song at the Australian Institute for Bioengineering and Nanotechnology (AIBN) is working on a fix: one that would allow HIV patients to take a long-acting antiretroviral dose once a week instead of a dose every day.

Backed by a $50,000 grant from the Australian Centre for HIV and Hepatitis Virology Research, Dr Song and AIBN Senior group leader Professor Michael Yu are embarking on a 10-month proof-of-concept study to simplify the timing of oral antiretroviral dosages and, hopefully, boost patient compliance levels.

“Our mission is simple: to make it easier for HIV patients to stick to their antiretroviral routine,” Dr Song said.

“Easing the burden of daily medication management will for sure bring a huge relief to the HIV patients. Instead of intake every day, what if HIV patients only had a day out of the week where they had to do it?”

Dr Song said there are many reasons why people failed to adhere to their prescribed antiretroviral regime, including a range of socioeconomic and cultural pressures, a lack of knowledge about HIV treatments, and even because of adverse drug reactions.

But the impact of nonadherence is clear. Patients whose antiretrovirals are taken correctly but less than 80 per cent of the time still experience a significant decline in the viral suppression to as low as 20 per cent.

“It’s wrong to assume that nonadherence is because a patient has simply not bothered to do it, or is ignoring the problem,” Dr Song said.

“But nonadherence, for whatever reason, remains a big issue. Unless you’re getting your meds right 95 per cent of the regime or more, you are looking at a greatly reduced medication performance.”

The nano-delivery system at the heart of Dr Song’s project is based on spiky nanoparticle technology that he has already developed, patented, and used for antimicrobial delivery, nutrition delivery and mRNA vaccine delivery.

Much like pollen grains with a distinct spiky surface sticking to the legs of a honeybee, Dr Song hypothesises that his spiky nanoparticles can be engineered to stick to a HIV patient’s gastrointestinal tract, which would prolong the release of antiretroviral drugs into the body.

“This project is highly outcome-oriented, with a commercially competitive nano-formulation developed with direct comparison to current dolutegravir medication of Tivicay,” Dr Song said.

“We’re hoping the proof-of-concept dataset will attract interest from major pharmaceutical industries to further validate the pharmacokinetics and safety profiles before a potential Investigational New Drug (IND) Application and prospective human trials.”

“Moreover, as a platform technology, it can simplify the medication regimen at the same time combining multiple drugs into a single tablet, which ultimately will benefit complex HIV treatments and enhance patient outcome.”