Long-Acting Lenacapavir Shows Viral Suppression at 26 Weeks
The phase II/III CAPELLA trial was conducted to assess the efficacy and safety of lenacapavir, a first-in-class capsid inhibitor. The study showed that, after 26 weeks, 81% of heavily treatment experienced people with HIV in a randomized cohort who were treated with a subcutaneous injection of lenacapavir combined with an optimized background antiretroviral regimen achieved sustained virologic suppression, with an undetectable viral load (<50 copies/mL). Lenacapavir-treated patients also achieved a clinically meaningful mean increase in CD4 counts of 81 cells/μL throughout the 26 weeks. the study investigators found that the drug was welltolerated, with no drug related serious adverse events or adverse events leading to discontinuation. “With regulatory approval, lenacapavir could become the only HIV-1 treatment option given every 6 months,” the study’s lead author said in a statement “These data support the use of lenacapavir in patients with multidrug-resistant viruses, and according to its long half-life of two subcutaneous injections per year, it could help reduce pill burden.” He added that providing a drug administered every 6 months subcutaneously offers an ideal treatment for overcoming resistance and lack of adherence to an HIV treatment regimen.
On-Demand PrEP Vs. Daily Use Among MSM
Researchers seeking to compare event-driven HIV prevention with which individuals only took medication before and after sex with dailyregimens among men who have sex with men(MSM), reviewed the cases of 520 MSM who
selected a daily regimen, 503 who selected an event-driven regimen, and 507 who declined to initiate PrEP. Those initiating PrEP were younger than non-users (age 29 vs 33, respectively) and had higher scores for risk behaviors. At-risk MSM who were unwilling to initiate PrEP acted as a control group. The authors followed up with participants every 3 months for up to 12 months. During the follow-up period, all PrEP users had a relative reduction of 87% in HIV infection, while adherent PrEP users experienced 100% risk reduction. Incidence rates of HIV infection were lowest among event-driven PrEP users (0.37 per 100 person-years), followed by daily PrEP users (0.90 per 100 person-years), and they were unsurprisingly higher among PrEP non-users (5.10 per 100 person-years). A study co-author noted that PrEP can reduce HIV risk among MSM in a real-world setting, with event-driven PrEP
offering “a better HIV protective effect.
