Lenacapavir: Advancing HIV Control Requires Resistance Vigilance and Equitable Access
DOI:
https://doi.org/10.63501/xrbdcv05Keywords:
Lenacapvir, HIV prevention, MDR HIV, Drug Resistant HIV, Long-acting injectableAbstract
Lenacapavir is a long-acting HIV-1 capsid inhibitor proven to be effective against preexposure prevention (PrEP) and multidrug-resistant HIV. It can be injected subcutaneously every six months, a major advancement in HIV prevention and treatment. Very high rates of viral suppression and prevention have been seen in clinical studies including CAPELLA and CALIBRATE; in the lenacapavir arm of a large PrEP study, there were no infections. Despite these successes, two major issues remain: the emergence of resistance-related mutations (RAMs) like Q67H and N74D and the challenge of global travel brought on by high prices and limited licensing. Better resistance monitoring, the development of next-generation capsid inhibitors, inexpensive diagnostics, pricing modifications, and research including underprivileged locations are all required for lenacapavir to provide its power to the fullest extent. Lenacapavir: Without these joint efforts, lenacapavir runs the risk of becoming a transformative treatment only accessible to a select elite.
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