An overview of the anti-HIV market.

HIV can destroy the body's immune system, but there is currently no effective cure for AIDS, the full name is "acquired immunodeficiency syndrome" (AIDS), is HIV virus, the human immunodeficiency virus caused by a very high rate of death of malignant infectious diseases.
HIV invades the body, can destroy the body's immune system, so that infected people gradually lose resistance to a variety of diseases, and eventually lead to death.
there is no vaccine to prevent, and there are no effective drugs or methods to cure the disease.
AIDS was named in 1982 and its pathogen was discovered in 1983, which is one of the most difficult medical problems at present.
HIV is classified as a primate immunodeficiency virus subsection in the retrovirus genus Retrovirus.
two main types of HIV virus have been detected, namely HIV-1 and HIV-2.
HIV-1 is a virus isolated from Europe and the Americas, and monkey HIV virus is only about 45% similar, very pathogenic, is the main cause of the global AIDS epidemic.
hiv-2 and monkey HIV virus similarity of up to 75%, its toxicity is weak, causing AIDS has a longer course of disease, mild symptoms, and mainly confined to West Africa.
so the research on HIV is mainly focused on HIV-1.
1 HIV virus structure diagram, data source: Modern Molecular Biology 4Th edition above is a diagram of HIV virus structure.
HIV particles are globular viruses about 100 nm in diameter, and the particles are outsourced by lipid membranes consisting of two layers of lipids, which bind to many glycoprotein molecules (mainly gp41 and gp120) that originate from the outer membrane of the host cell.
proteins p24 and p18 make up its core, containing genomic RNA chains with reverse transcriptases attached to them, which catalyz the reverse transcription of viral RNA.
about 1.1 million people in the U.S. are currently infected with HIV, about 15 percent of whom don't know they've been infected, according to data released by the Centers for Disease Control and Prevention.
2016, about 38,700 Americans were newly infected with HIV.
, bisexuals, and other men who have sex with men are at the highest risk of infection, with an estimated 2,600 new infections each year.
2017, 38,739 people were diagnosed with HIV throughout the United States, and the number of new HIV diagnoses in the United States has remained stable each year since 2013.
, there are regional differences in HIV infection, with 19968 (52 percent) of newly diagnosed HIV infections in the U.S. in 2017 in the southern United States.
Figure 2 Trends in the number of people newly diagnosed with HIV in the United States, data source: Data released by the U.S. Centers for Disease Control and Prevention Nearly 42,000 people in the U.S. were diagnosed with HIV in 2010, up from about 39,000 in 2013.
38,900 in 2013 and 38,700 in 2016.
combined with 38,739 newly diagnosed HIV infections in 2017, the number of new cases in the United States is estimated to have stabilized and decreased slightly in recent years.
China, according to the China AIDS Guidelines (2018 edition), there were 36.9 million living HIV/AIDS (HUMAN IMMUNODEVIR/Access Immune Deficiency Syndrome) patients worldwide by the end of 2017, 1.8 million new HIV infections that year, and 21.7 million cases undergoing effective combined antiretroviral therapy (highlyactive antiretroviralrapy, HAART, Commonly known as "cocktail therapy" and now known as antiretroviral therapy).
On the basis of continuing to implement comprehensive and intensive interventions, the
90-90 strategy" is proposed, i.e. 90% of living HIV/AIDS patients are detected, 90% of HIV/AIDS patients diagnosed receive standardized HAART, 90% of HIV/AIDS patients treated have the virus suppressed, and the number of new infections will be controlled at less than 500,000 by 2020.
the end of 2017, 758610 cases of hiv/AIDS patients were reported in China, 134512 cases of HIV/AIDS patients were newly discovered that year (more than 95% of whom were infected through sexually transmitted infections), and 30718 deaths were reported that year.
Figure 3 The incidence of AIDS in China 2011-2019, data source: China's Centers for Disease Control and Prevention, as shown in the chart above, the National Statutory Infectious Diseases Report released by the China Center for Disease Control and Prevention shows that the number of people living with AIDS in China has increased rapidly in the last decade, from 20450 in 2011 to 72630 in 2019, with a compound annual growth rate of 17.17 percent, while the number of deaths in ten years has increased at a compound annual rate of 11.06 percent.
can be seen that in recent years, the AIDS population gradually expanded, and the mortality rate is high, is currently one of the more serious diseases.
cocktail therapy for the current recommended anti-HIV treatment program at present HIV virus can not be completely eliminated.
anti-HIV targets are: 1) plasma HIV RNA is reduced to undet detectable levels (i.e., 20 to 50 copies/ml);
most commonly used treatments are antiretroviral therapy (highly active antiretroviral therapy, HAART, commonly known as "cocktail therapy" and now known as antiretroviral therapy).
Currently, there are more than 30 drugs (including compound preparations) in 6 categories, namely nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), integrated enzyme inhibitors (INSTIs), membrane fusion inhibitors (FIs) and CCR5 inhibitors.
antiretroviral therapy drugs in China are NRTIs, NNRTIs, PIs, INSTIs, and FIs5 (including compound preparations).
U.S. clinical guidelines state that treatment options should be individually designed based on virological efficacy, potential adverse reactions, fertility potential and use of effective contraception, drug burden, frequency of administration, potential drug-drug interactions, common disease conditions, costs, accessibility, and drug resistance test results.
for first-time patients, the U.S. guidelines recommend a combined use of 1 INSTI and 2 NRTIs, and the recommended treatment options are shown in the table below.
Table 1 Recommends Antiviral Treatment Options for Adult and Adolescent Primary Patients Source: Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV Note: TDF for Tenofwe; ABC for Abakawe; 3TC for Ramifding; FTC for Entourtabin; TAF for Propofol Tenofowe; AZT for Zidolfding; DOR for Doltavel; BIC for Bictegravir; EFV for Efeveren; LPV/r for Lopinave/Litonaway; RAL for Latrobe; NVP for Nevelalpin; RPV for Lipivellin.
chinese treatment guidelines, adult and adolescent primary treatment patients recommended 2 NRTIs class backbone drugs combined with the third class of drug therapy.
the third class of drugs can be NNRTIs or enhanced PIs (including litonavir or cobbistha) or INSTIs; table
2 The main existing domestic antiretroviral drug data source: China AIDS diagnosis and treatment guidelines (2018 edition) from the table above, there are a variety of antiviral drugs, according to the need for single-drug or two-drug combination of antiviral treatment.
based on antiviral drugs available in our country, and recommended and alternatives for patients who have not received HAART are shown in the table below. Table
3 Recommends Antiviral Treatment Programs for Adults and Adolescents Antiviral Treatment Source: China AIDS Guidelines (2018 Edition) FOR HIV-infected children should start HAART as soon as possible, if there is no timely HAART, AIDS-related death rate in the first year of life reached 20%-30%, the second year can exceed 50%.
antiviral treatment options for children are shown in the table below.
Table 4 Children's Antiviral Treatment Program Data Source: China AIDS Guidelines (2018 Edition) 65 anti-HIV drugs have been listed worldwide, and 29 anti-HIV drug types currently available worldwide are distributed in the following table.
Table 5 Distribution of Anti-HIV Drug Types Worldwide Data Source: Drug Crossing Consulting, as shown in the table above, after 1995, a total of 65 anti-HIV drugs have been listed worldwide, including 50 in the United States and 29 in China.
drug market to chemical drugs mainly, in addition to chemical drugs, only 1 biological drug, 1 plant drug on the market.
34 innovative drugs, in addition to 1 modified new drug and 27 compound drugs.
the drugs currently on the market in China are chemicals, including 18 innovative and 11 compound drugs.
Ibalizumab, a monoclonal antibody developed by biopharmace to Biogen and targeted at CD4, was approved in the United States in 2018 and in the European Union in 2019.
plant drug, Nerium Biotechnology Inc., is a plant extract that was launched in South America in 2007.
-improved new drug is a Zidovudine pediatric preparation from Matrix Laboratories.
list of drugs listed in China.
Table 6 China-listed anti-HIV single drug data source: Drug Ferry Consulting has been listed in China's joint preparations as shown in the table below.
Table 7 China-listed anti-HIV co-preparation data source: Drug ferry consultation finishing in addition to the above-mentioned drugs, the Chinese government provides some anti-HIV drugs free of charge, the following table. table
8 Free anti-HIV drugs Data source: National Free AIDS Antiviral Drug Treatment Manual (Fourth Edition) As shown in the table above, the government currently provides more than 20 kinds of anti-HIV drugs free of charge, the above drugs can be used alone, can also be used jointly.
all people living with HIV, regardless of CD4 levels, can receive antiviral treatment.
the global anti-HIV market is more than $30 billion, and the prospect of cocktail therapy is promising with annual sales of $32.9 billion for anti-HIV drugs that will be sold in 2019.
North America is the largest market for anti-HIV drugs, with a market share of 74.2 per cent in 2019, 19.7 per cent in Europe, 5.8 per cent in Asia, Africa and Oceania, and only 0.3 per cent in Latin America.
Figure 4 Market share distribution of anti-HIV drugs, data sources: Drug ferry consulting as shown in the chart above, in anti-HIV drugs, cocktail therapy has accounted for more than 50% of the market share, followed by nucleoside retrovirase inhibitors, and membrane fusion inhibitors drug market share of less than 1%.
10 anti-HIV drugs for sales in 2019 are listed below.
Table 9 The top 10 anti-HIV drugs for sales in 2019 Are the top 10 anti-HIV drugs for sales in 2019, mostly compound drugs, only 2 single drugs, and need to be used in clinical use in cooperation with other drugs.
five of the top 10 anti-HIV drugs in sales were produced by Gilead, which accounted for 53.3 percent of the market.
shows Gilead's dominance in the fight against HIV.
of these drugs, Truvada ®, in addition to treatment, has been approved for pre-exposure prevention to reduce the spread of HIV among high-risk populations.
In the Chinese market, although there are more than 30 drugs in the market, but because the government provides some drugs free of charge, although such drugs have certain side effects, but because anti-HIV drugs need to be taken for a long time, the cost is higher, most patients still tend to choose free drugs, so the size of the Chinese market is more limited.
Figure 5 Sales in China's Anti-HIV Market, Source: Frontier Bio prospecto As shown in the table above, China's anti-HIV market is currently booming, with annual sales growing from 790 million yuan in 2013 to 20.2 in 2018 Billion yuan, a compound annual growth rate of 20.65 percent, the growth of the domestic market mainly benefited from the growth of tinofove diformide, due to the expiration of its patents in 2017, mainly in Chengdu Pt and Zhengda Tianqing domestic enterprises to develop generic drugs, further seize the market.
the anti-HIV market will continue to grow at a high rate in the future, reaching nearly 5 billion yuan in 2023 and a compound annual growth rate of 18.6% in 2018-2023.
concluded that HIV infection is currently not cleared, can only reduce the viral load to a certain extent, making it non-contagious, and the patient asymptomatic.
commonly used HIV treatment for cocktail therapy, using a combination of drugs, play a role in the known virus.
currently has 65 anti-HIV drugs, including 29 in China.
more than $30 billion in global markets for anti-HIV drugs, with the United States accounting for the majority of the market.
cocktail therapy contributes more than 50% of sales.
and Gilead, which has a market share of more than 50%, is the leader in the field of anti-HIV drugs.
China's anti-HIV market is currently in a state of vigorous growth, with annual sales increasing from 790 million yuan in 2013 to 2.02 billion yuan in 2018, and is expected to be anti-HI in the future.