Human immunodeficiency virus (HIV) targets the immune system and weakens the patient’s defense system against many infections and some types of cancer. The virus destroys and impairs the function of immune cells, infected individuals gradually becoming immunodeficient. According to the National Institute of Dental and Craniofacial Research, people with HIV that causes acquired immunodeficiency syndrome (AIDS), are at special risk for oral health problems. Some of the most common oral problems for people with HIV/AIDS involve chronic dry mouth, gingivitis, bone loss around the teeth ((periodontitis), canker sores, oral warts, fever blisters, oral candidiasis (thrush), hairy leukoplakia (which causes a rough, white patch on the tongue), and dental caries. Combination antiretroviral therapy, which intends to treat the HIV condition and restore immune function, has made the oral associated problems less common.

Growth Factors

High government involvement for increasing awareness among people bolsters the growth of oral HIV treatment market globally

In the US, December is HIV/AIDS Awareness month and the US Department of Veterans Affairs (VA) reminds population pinpointing the importance of testing. The VA is the single largest provider of HIV care in the US, offering care to more than 26,000 Veterans with HIV since 2012. Yet only 25% of the Veterans have been tested for HIV. AIDS is the final stage of HIV infection. One in 5 of the more than one million people living with HIV in the US are unaware about the infection. As per the Avert, sex education in schools is widespread in Western Europe, with many countries in this region taking a comprehensive approach by involving topics such as gender inequality and gender norms coupled with topics such as pregnancy, contraception, and sexually transmitted diseases (STIs) involving HIV. Moreover, Western Europe and Central Europe has witnessed 55% decline in new HIV infections between 2010 and 2016.

Additionally, the European Center for Disease Prevention and Control (ECDC) provides comprehensive guide to effectively use digital platform for sexually transmitted disease (STI) prevention. The guides in collaboration with the Terrence Higgins Trust (THT) and STI AIDS Netherlands (SANL) incorporate the expertise with EU members and engaging with commercial sector to best practice and engagement with the platform companies.

Combination therapy prove beneficial for the treatment for global oral HIV treatment market

Combination therapy dramatically reduces the likelihood of drug resistance (many drug resistant mutation are mutually exclusive) and suppresses viral replication to the point that progression of aids is significantly slowed. In January 2021, The US Food and Drug Administration (USFDA), approved Vocabria (cabotegravir, tablet formulation) taken in combination with oral rilpivirine (Edurant). The dosage is prescribed for one month for treatment of HIV. Additionally, according to the estimates released by the Avert, the oral pre-exposure prophylaxis (PrEP) was provided to 2,500 men who had sex with men at 11 sites in six countries on four continents involving Brazil, Ecuador, Peru, South Africa, Thailand and the USA). It was found that the HIV infection rate in HIV-negative gay men who were prescribed with PrEP was reduced to 44% compared with men taking a placebo. Moreover, oral PrEP at six hospitals in France and Canada, reported an 86% reduction in the HIV infection rate compared to those taking a placebo. Furthermore, the Partners PrEP trial recruited around 4,750 heterosexual couples in which one partner was living with HIV across Uganda and Kenya. It was witnessed that the HIV infection was reduced by 62% among those who consume oral tenofovir and 73% among those who received Truvada. The pill brand name (Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. PrEP is highly effective for treatment of HIV. According to the Center for Disease Control and Prevention (CDC), PrEP reduces the risk of getting HIV from sex by about 99% if consumed daily.

Segmental Review

Oral HIV treatment market is segmented based on drug class. The drug class comprises of nucleoside-analog reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), multi-class combination therapies, protease inhibitors (PIs), entry and fusion inhibitors, and co-receptor antagonists. Based on the drug class, the Nucleoside Analog Reverse Transcriptase Inhibitors (NRTIs) hold the largest market share contributing for the growth of oral HIV treatment market globally. This is highly supported due to surge in adoption of drugs from this medication class resulting in better results for controlling the HIV & related co-infections on consumption & adherence. The first agent of this category “zidovudine” became available in 1987. “Zidovudine” mono therapy shows better clinical trials resulting in decreasing mortality, increasing CD4+ counts and lead to fewer opportunistic infections in patients with symptomatic HIV infection and AIDS. Two nucleoside analogs constitute the first combination antiretroviral regimen.

The combination therapy with "zidovudine" and "zalcitabine", "zidovudine and didanosine", or "zidovudine" and "lamivudine" has shown promising results clinically and proven more effective in producing and increasing the CD4+ count or a decrease in the viral load.

Regional Landscape

North America holds the dominating share for the oral HIV treatment market worldwide

North America shown promising results in terms of market share in the past and it is projected that it will continue the same trend in the forthcoming years. High government involvement coupled with launching of several awareness programs, high prevalence of oral HIV patient pool, and technological advancements contribute to the fullest for the growth of oral HIV treatment market globally. As per the estimates revealed by the Minority HIV/AIDS Fund, in 2018, 36,400 new HIV infections were detected in the US. However, 37,968 people received an HIV diagnosis in the US and 6 dependant areas-an overall 7% decrease as compared to 2014. Additionally, Centre for Disease Control and Prevention (CDC) statistics, about 14% (or 1 in 7) people are living with HIV in the US are unaware and require testing. An estimated 44.9% of young people aged 13-24 suffering from HIV are unaware of the infection. The US response to such global epidemic is launching of the US President's Emergency Plan for AIDS Relief (PEPFAR). This is one of the US Government responses to the global HIV/AIDS epidemic representing the largest commitment by any nation to address a single disease in history.

Among the estimates revealed by the Minority HIV/AIDS Fund, PEPFAR provided HIV testing services for 79.6 million people in fiscal year 2019, and as of September 2019, supported lifesaving antiretroviral therapy (ART) for nearly 15.7 million men, women, and children.

Competitive Landscape

The report provides a comprehensive analysis of prominent players operating in the oral HIV treatment market. These involve Cipla Limited, AbbVie Inc., Gilead Sciences, Inc., Boehringer Ingelheim International GmbH, Merck & Co., Inc., Pfizer Inc., GlaxoSmithKline plc., Johnson & Johnson, F. Hoffmann-La Roche Ltd., Teva Pharmaceutical Industries Ltd., and among others.

Market Segmentation

Market By Drug Class

Nucleoside-Analog Reverse Transcriptase Inhibitors (NRTIs)
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Multi-Class Combination Therapies
Protease Inhibitors (PIs)
Entry And Fusion Inhibitors
Co-Receptor Antagonists

Market By Geography

North America

• U.S.
• Canada

Europe

• U.K.
• Germany
• France
• Spain
• Rest of Europe

Asia-Pacific

• China
• Japan
• India
• Australia
• South Korea
• Rest of Asia-Pacific

Latin America

• Brazil
• Mexico
• Rest of Latin America

Middle East & Africa

• GCC
• South Africa
• Rest of Middle East & Africa