Chapter 9: Opportunities and Challenges in Nanotechnology-enabled Antiretroviral Delivery

The introduction of modern antiretroviral chemotherapy has significantly improved the morbidity and mortality associated with HIV infection. However, there are many factors that can contribute to the success of antiretroviral therapy including, but not limited to; patient adherence, genetic variability in drug disposition and pharmacokinetic pathways, the natural history of HIV itself, adverse drug reactions, and drug–drug interactions. Nanoformulation offers opportunities to overcome some of these limitations by simplifying dosing, improving pharmacokinetics and/or mitigating off-target toxicities through improving penetration of antiretrovirals into anatomical and cellular sanctuary sites. However, nanomaterials exhibit the potential to interact with the immune system raising the possibility of unwanted side effects. In the context of HIV-infected individuals, such side-effects may be influenced by dysregulation in the immune system as a consequence of the disease. The aim of this chapter is to provide an overview of current progress in nanotechnology-enabled drug delivery in HIV. Current knowledge of the impact of HIV-infection on the immune system is also summarized, in the context of how this may be expected to influence known immunological safety concerns with specific nanotechnologies.