Today, people infected with HIV can live normal, longer and healthier lives thanks to the various forms of treatment modalities available today. One such form of treatment is antiretroviral therapy for HIV (Palella, FJ et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N. Engl. J. Med. 338, 853–860 (1998). Antiretroviral drugs help manage HIV in infected individuals by hindering the duplication process of the HIV virus. Various antiretroviral drugs are used in combination with each other to achieve maximum suppression of the HIV virus (Arts EJ, Hazuda DJ. HIV- 1 Antiretroviral Drug Therapy. Cold Spring). Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative study). Say no to plagiarism. Get an original essay Despite the availability of new treatments such as ART to manage HIV, studies have shown that non-adherence to antiretroviral therapy by individuals infected with the HIV virus can significantly influence the success of antiretroviral therapy ( Mills, E. J. et al. Adherence to antiretroviral therapy in sub-Saharan Africa and North America: a meta-analysis. JAMA 296, 679–690 (2006), and Lima, V. D. et al highly active antiretroviral therapeutics and adherence to mortality over time. J. Acquire. Sindr. Factors such as high costs and poor accessibility or availability of drugs, unexpected personal situations, and social acceptance of HIV patients can cause non-adherence to antiretroviral therapy. Patients are known to adhere to their treatment program during the first few sessions of therapy. As therapy progresses, patients become less adherent (Bangsberg, DR & Mills, EJ Long-term compliance to antiretroviral therapy in resource-limited settings: a bitter pill to shut down. Antivir. Ther. 18, 25–28 (2013) Chesney MA et al. (2000) report the Adult AIDS Clinical Trials Group (AACTG) Adherence Instruments to obtain data on medication adherence. The AACTG Adherence Instruments consist of two sets of questionnaires lasting approximately 10 minutes each participated in 75 HIV-positive individuals undergoing ART study at 10 AACTG sites in the United States reported that “11% of patients reported missing at least one dose the day before the interview and 17. % reported missing at least one dose in the previous two days The most common reasons for missing medications included “just missed” medications (66%) and a variety of factors often associated with improved health, including being. busy (53%), away from home (57%) and changes in routine (51%). need to develop a stable drug delivery system that allows the long-term, consistent and timely administration of antiretroviral drugs to HIV patients (Fasano, A. Innovative Strategy for the Oral Delivery of Drugs and peptides. Biotechnology Trends. 16, 152–157 (1998). Such a drug delivery system would greatly alleviate the stress experienced by patients following a daily drug use schedule, reducing the chances that patients will forget to consume their prescribed antiretroviral drugs and that patients will have to holdtrack their drug use (Mobula L, Barnhart M, Malati C, Rakhmanina N, Minior T, et al. (2015) Long-acting injectable antiretroviral therapy for the management of HIV infection: an update on a potential game changer. doi:10.4172/2155-6113.1000466). An oral antiretroviral drug delivery system, although efficient and widely used, cannot tolerate the low pH of stomach acids for long periods (Mojaverian, P. Evaluation of gastrointestinal pH and gastric residence time via the Heidelberg radiotelemetry capsule: Pharmaceutical Application. Drug Dev. Res. 38, 73–85 (1996). AR Kirtane et al. (2018) developed and studied a modular drug delivery system for HIV which folds and retracts, allowing oral administration, which maintains its integrity in the stomach for a prolonged stay and which can be loaded with up to 100 mg six different pharmacological formulations that determine the desired pharmacokinetics" and "is capable to release three highly potent antiretrovirals – dolutegravir (DTG), cabotegravir (CAB) and rilpivirine (RPV) – for one week after a single dose in a porcine model." the antiretroviral drug delivery system studied in AR Kirtane et al. (2018) is an inception-shaped model has “six arms”, capable of delivering six different drugs at desired rates, connected by a “central core” (Fig. 1a). The six arms of this model, connected in the center, bend over each other. This system is then enclosed within a shell to form an orally ingestible capsule. Once the capsule comes into contact with stomach acids, the shell disintegrates and the six arms open into a star shape and begin to release the drug loaded on each arm. The materials used to build the model's arms had to have "stiffness for gastric residence and adaptability of drug release." AR Kirtane et al. (2018) report using various “mechanical tests” whose results produced “an Elastollan®R6000 thermoplastic polyurethane” that “exhibited ultimate bending stress.” Early drug models consisted of a single type of polymer that made up the core and arms of the model. Therefore, this polymer was responsible for providing rigidity to the structure and dispensing drugs. This became a problem when designing a model capable of releasing drugs at variable rates because the rigidity of the model was compromised when the polymer configuration was altered (the new drug capsule could enable weekly treatment of HIV. The replacement daily pills with a weekly regimen could help patients stick to their dosing schedule, Anne Trafton, MIT News Office, January 9, 2018 http://news.mit.edu/2018/new-drug-capsule-may- allow-weekly-hiv-treatment-0109). AR Kirtane et al. (2018) report the use of “tensile testing” methods to select polymers for the construction of central cores. “An Elastollan®1185 thermoplastic polyurethane” was selected because it had an “elastic modulus of ~27.7 ± 2.2 MPa.” Ultimately, the structural polymer Elastollan®R6000 and the core elastomeric polymer Elastollan®1185 were selected for model construction because they demonstrated “the highest value for maximum stress (~12.1 ± 1.2 MPa) (n = 3)” and tolerated gastric acid without disintegration for up to 7 days. AR Kirtane et al. (2018) tested antiretroviral drugs “DTG (an integrase inhibitor), CAB (an integrase inhibitor), RPV (a non-nucleoside reverse transcriptase inhibitor), and tenofovir alafenamide (TAF, a nucleotide inhibitor.