Antiretroviral (ARV) therapy, comprising a backbone of two nucleos(t)ide reverse transcriptase inhibitors (NRTIs) plus another ARV, has helped extend life expectancy in people living with HIV (Orkin et al. 2018).
Lopinavir is an antiretroviral protease inhibitor used in combination with other antiretrovirals in the treatment of HIV-1 infection. Like many other protease inhibitors, lopinavir is a peptidomimetic molecule; it contains a hydroxyethylene scaffold that mimics the peptide linkage typically targeted by the HIV-1 protease enzyme but which itself cannot be cleaved, thus preventing the acivity of the HIV-1 protease (Reddy et al. 2007). Another HIV protease inhibitor, darunavir, prevents HIV replication through binding to the enzyme, stopping the dimerization and the catalytic activity of HIV-1 protease (De Meyer et al. 2005). In particular, it inhibits the cleavage of HIV encoded Gag-Pol proteins in cells that have been infected with the virus, halting the formation of mature virus particles, which spread the infection (Davis et al. 2012).
Lopinavir in combination with other drugs is currently being investigated for patients with COVID-19 (many clinical trials, example registration nos. ChiCTR2000029603, ChiCTR2000029539, NCT04255017, NCT04261270) (Harrison 2020, Cao et al. 2020, Deng et al. 2020, Martinez 2020).