Lenacapavir a game changer in stopping new HIV infections
By Shahista Namale
The campaign to end new HIV infections by 2030 has been boosted with the production of Lenacapavir drug that research has showed achieved 100 percent efficacy in presenting new infections. Now advocates want the drug readily available to those who need it especially the most vulnerable groups such as women and girls. Bridget Jjuuko a fellow at Aids Vaccine Advocacy Coalition [AVAC] called for the speedy production of the drug so that it can benefit all those who need it. “We don’t want Lenacapavir at the expense of other modalities but as an addition to expand choice for girls and women. What we need to be focusing on is having Lenacapavir to the people that need it without disrupting other HIV prevention options that are already available,” Jjuuko said. Lenacapavir, is an injectable drug taken twice a year to prevent HIV infections. Uganda and South Africa were two of the countries where research to establish the efficacy of the drug was carried out. Jjuuko thanked Gilead the producer of the drug for centering communities and upholding ethical research practices in the Purpose 1 trial. “We have learnt a lot from the rollout of Oral Prep, from the introduction of the depivirine ring and most recently the injectable cabotegravir. We really hope that these lessons will help speedup the regulatory approvals, manufacturing and development of guidelines in the different countries and a robust equitable and sustainable access plan across different geographies,” Jjuuko said. She added that it is very important to make communities understand and accept Lenacapavir as this will create demand that will then lead to a reduction in the price of the drug.
“The way communities came together to inform science for the Purpose 1 study is the same way we need to build a market and create demand because big volumes help to drive prices down,” Jjuuko said.
The trial tested whether the six-month injection of lenacapavir would provide better protection against HIV infection than two other drugs; both daily pills. All three medications are pre-exposure prophylaxis (or PrEP) drugs. Speaking to journalists through zoom, Mitchell Warren, AVAC’s executive director said this was one of the most important results in the prevention matrix.
“This is one of the most important results we’ve seen to date in an HIV prevention study. Additional HIV prevention options means more people may find an option that is right for them. Beyond expanded choice, a twice-yearly injection has the potential to transform the way we deliver HIV prevention to people who need it most,” Warren said. The injection is expected to be available in countries that account for most of the global disease burden. The price of the injection is currently high, at around $40,000 per year, but Gilead has indicated that it will license generic manufacturers to produce the drug, which will lead to significant price reductions.
In Uganda the study was carried out through a collaboration between Makerere University and John Hopkins University [MU-JHU]. Dr Flavia Matovu Kiweewa the director of research at MU-JHU and the Uganda national principal investigator for the Purpose 1 study said they were encouraged by the results. “Lenacapavir will change the approach to HIV pre-exposure prophylaxis worldwid. I thank the research participants in Uganda and South Africa who volunteered their time,” Kiweewa said. The research in the two countries involved 5300 participants. Meanwhile, a companion trial, Purpose 2 is underway in Argentina, Brazil, Mexico, Peru, South Africa, Thailand and the US, Results are expected in early 2025.
