Pharmacologic drug classes include:
Nucleoside reverse transcriptase inhibitors (NRTIs)
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Protease inhibitors (PIs)
Integrase inhibitors (INSTIs)
Fusion inhibitors (FIs)
Chemokine receptor antagonists (CCR5 antagonists)
***Protease inhibitors (PIs) are a class of antiviral drugs that are widely used to treat HIV/AIDS and hepatitis C. Protease inhibitors prevent viral replication by selectively binding to viral proteases (e.g. HIV-1 protease) and blocking proteolytic cleavage of protein precursors that are necessary for the production of infectious viral particles.
Protease inhibitors that have been developed and are currently used in clinical practice include:
Antiretroviral HIV-1 protease inhibitors — class stem –navir
Hepatitis C virus NS3/4A protease inhibitors — class stem –previr
Given the specificity of the target of these drugs there is the risk, as in antibiotics, of the development of drug-resistant mutated viruses. To reduce this risk it is common to use several different drugs together that are each aimed at different targets.
In the race to find effective treatments or a cure for COVID-19, researchers are now testing antiretrovirals used to treat HIV such as lopinavir, ritonavir, and another protease inhibitor called darunavir.
There is anecdotal evidence to suggest that anti-HIV drugs may be effective. Thai doctors gave lopinavir and ritonavir in combination with a flu drug to a Chinese coronavirus patient, who tested negative for the virus within two days. In Japan, a patient from Wuhan, China, was treated with just the two HIV drugs and her fever subsided within five days of being admitted to the hospital. And a report in the journal JAMA in March 2020 showed that three of five patients recovered after being treated with the same two drugs.
These reports are encouraging, but public health experts caution that more testing is needed before concluding that the HIV drugs can effectively treat COVID-19.