More than a million people are infected with HIV each year and there is still no vaccine to prevent it. However, a drug that is injected twice a year has demonstrated total effectiveness in preventing infection and, for this reason, it has been chosen by Science magazine as the most important advance of the year. This is lenacapavir, developed by Gilead, which in June this year reported that a large clinical trial had shown that it completely prevents infection in adolescents and young women in Africa.
In case there was any doubt about its effectiveness, three months later a similar trial conducted on four continents showed 99.9% effectiveness in gender-diverse people who have sex with men. Lenacapavir attacks the viral capsid protein and when administered as an injection its effectiveness exceeds that of oral medications because it acts for a much longer interval: 6 months, so it is only necessary to administer it twice a year.
Antiretroviral medications reduce HIV levels to stop transmission and, although they can also reduce the risk of infection, their effectiveness depends on taking them daily, something difficult to achieve due to problems of access, patient adherence and social stigma. , especially among women and girls in African countries.
Anti-HIV medications are necessary because non-pharmacological methods – such as condoms, needle exchange programs and education – face similar challenges: the difficulty of ensuring their consistent use to stop the spread of the virus. The ability of lenacapavir to prevent HIV transmission for six months is a breakthrough because it offers a more practical and effective solution to bring prophylaxis to more people around the world.
Reduce HIV infection rates worldwide
Many HIV/AIDS researchers are now hopeful that lenacapavir will significantly decrease infection rates globally when used as pre-exposure prophylaxis (PrEP). “It has potential, if we do it right, which means we need to do it big and spread it,” said Linda-Gail Bekker, an infectious disease specialist at the University of Cape Town, who led one of the two efficacy trials. for the drug manufacturer, in a note published in Science.
“The subcutaneous administration of lenacapavir every six months prevents possible HIV infection by 100%”
In Science they point out that the ability of lenacapavir to “accelerate the end of the HIV/AIDS epidemic will depend on access, distribution and, of course, demand. Its approval will arrive, at the earliest, in mid-2025, and its price, still unannounced, will determine who can afford it.” In Spain, lenacapavir (marketed under the name Sunlenca) has been available since July of this year.
“Lenacapavir is the first of a new family of antiretrovirals that inhibit the formation of the HIV capsid. It is a molecule that allows its oral administration (daily or weekly) or parenterally subcutaneously every six months. In 2024, a very important study was published that shows that the subcutaneous administration of lenacapavir every six months prevents possible HIV infection by 100%. In the clinical development of lenacapavir, its use is planned for prophylaxis and treatment of infected people (along with other antiretrovirals). Due to the impact that all of this can have on the control of the HIV pandemic, it undoubtedly deserves to be considered the most important medical advance of this year,” says Josep Mallolas, head of the HIV-AIDS unit at the Hospital Clínic-Barcelona. in statements to Science Media Center Spain.
