If the infected CD4+ cell is activated — which happens any time the immune system is called upon to respond to an infection or allergen or cancerous cell — instead of performing its proper functions, it will start making and releasing new virus. The first step is to make long chains of viral protein. The protease enzyme works like scissors to cut these protein chains into the smaller pieces that make up HIV. The newly cut pieces are assembled into new virus particles, which then “bud” out from the host cell and can go on to infect other cells.
Protease inhibitors (PIs) are drugs that interfere with the action of protease. They prevent the protease enzyme from cutting the long chains of new viral protein. Although new virus can be formed, it is defective and cannot infect new cells. Protease inhibitors have a very powerful ability to suppress the virus and are an important part of many drug combinations.
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