New Therapy May Effectively Control HIV in Uganda | Newsroom

Lenacapavir: A Promising New Weapon Against HIV in East Africa

Emerging research paints a promising picture for lenacapavir, a novel HIV therapy, in combating the HIV epidemic in east Africa.

A recent multi-national study,coordinated by Weill Cornell medicine investigators adn published January 30th in the Journal of Antimicrobial Chemotherapy,revealed minimal resistance to lenacapavir among HIV patients in Uganda. The study, which involved researchers from Mbarara University of Science and Technology in Uganda and Massachusetts General Hospital in Boston, analyzed the capsid proteins of HIV-1 subtypes A1 and D from 546 Ugandan patients who had never previously received antiretroviral therapy.

“Our data shows that only 1.6% of the individuals studied are living with HIV strains that have any known lenacapavir-associated resistance mutations,” said Dr. Guinevere Lee, assistant professor of virology in medicine at Weill Cornell Medicine and the study’s senior author.“That’s important because it shows lenacapavir is likely to be effective against strains of HIV circulating in East Africa.”

For decades, combination therapies targeting different stages of the HIV life cycle have successfully suppressed viral loads to nearly undetectable levels. However, the emergence of drug-resistant strains poses a significant threat to long-term treatment success. Lenacapavir stands out as the first drug to directly attack the protective capsid layer surrounding HIV’s genetic material, effectively blocking the virus’s replication and transmission.

Clinical trials have demonstrated lenacapavir’s efficacy in both treatment-naïve individuals and those with HIV strains resistant to other drugs. Last year, landmark clinical trials showed lenacapavir injections to be 100% effective in preventing HIV infection among HIV-negative women in sub-Saharan Africa.

Despite these promising results, limited data existed on the prevalence of pre-existing lenacapavir resistance in less-studied HIV-1 subtypes prevalent in Eastern and Southern Africa. While resistance mutations are uncommon in HIV-1 subtype B strains, which primarily affect Europe and the United states, subtype A1 and D strains, more common in East Africa, presented an uncertain scenario.

This Ugandan study fills a crucial gap in our understanding of lenacapavir’s potential effectiveness in these regions. The researchers discovered that none of the 546 ugandan patients had genetic mutations that could lead to major lenacapavir resistance. Only nine participants exhibited minor mutations with the potential to partially reduce drug efficacy, but not enough to cause full resistance.

“Our study supports lenacapavir’s potential efficacy in this region. As lenacapavir is rolled out in East Africa, further studies will need to monitor for the emergence of drug-resistant strains,” Dr. Lee emphasized. “It is indeed crucial that we ensure HIV research reaches understudied communities where unique viral strains circulate.”

Lenacapavir represents a significant advancement in HIV treatment, offering a powerful new tool to combat the virus, particularly in regions where drug resistance is a growing concern. Continued research and monitoring are essential to ensure the long-term effectiveness of this promising therapy.

What are the potential implications of lenacapavir’s long-acting formulation for HIV treatment and prevention efforts in East Africa?

Lenacapavir: A Promising New Weapon Against HIV in East Africa

Interview with dr. Aditya Patel, Infectious Disease Specialist and HIV researcher

Archyde’s Senior Health Editor recently sat down with Dr.Aditya Patel, an infectious disease specialist and HIV researcher with extensive experience in East Africa, to discuss the exciting developments surrounding lenacapavir, a novel HIV therapy showing great promise in the region.

Dr. Patel, can you tell our readers a bit about lenacapavir and what makes it unique in HIV treatment?

Dr.Patel: Lenacapavir is a long-acting HIV therapy that targets the virus’s capsid protein. Unlike traditional antiretroviral therapies that target specific enzymes or receptors in the HIV life cycle, lenacapavir directly attacks the protective shell surrounding HIV’s genetic material, blocking its replication and transmission.This unique approach makes it a promising addition to our HIV treatment arsenal.

we’ve heard about lenacapavir’s success in clinical trials. How effective is it against HIV strains prevalent in east africa, specifically subtypes A1 and D?

Dr. Patel: A recent study led by Weill Cornell Medicine and involving researchers from Uganda and the US addressed this critical question. The study found that less than 2% of HIV patients in Uganda who had never received antiretroviral therapy had strains resistant to lenacapavir. This is excellent news for East Africa, as it suggests that lenacapavir could be highly effective against the dominant HIV strains circulating in the region.

That’s encouraging. Could you elaborate on the implications of these findings for HIV treatment in East Africa?

Dr. Patel: These results have significant implications for HIV treatment and prevention in East Africa. Lenacapavir’s long-acting formulation means patients may require less frequent dosing, improving adherence and reducing the risk of resistance due to poor adherence. Moreover, its potency against drug-resistant strains provides hope for individuals who have failed prior therapies. Lastly, its triumphant use in preventing HIV infection among high-risk women in sub-Saharan Africa offers hope for pre-exposure prophylaxis (PrEP) programs in the region.

Why is it crucial to study lenacapavir’s efficacy against unique HIV strains found in East Africa, like subtypes A1 and D?

Dr. Patel: Previous HIV research has mainly focused on subtype B strains prevalent in Europe and the US. Though, HIV strains in East Africa, like subtypes A1 and D, can behave differently and may respond uniquely to certain therapies. Studying lenacapavir’s effectiveness against these regional viral strains ensures that any HIV treatment strategy developed is tailored to the specific needs of the affected populations, ultimately helping to arrest the epidemic in the region.

Looking ahead, what do you think are the most vital next steps for lenacapavir research and implementation in East Africa?

Dr. Patel: As lenacapavir rolls out in East Africa, continued monitoring for drug-resistant strains will be vital. We should also focus on integration with existing HIV treatment and prevention programs to maximize its impact. Additionally, further research should explore lenacapavir’s potential use in other innovative HIV treatment strategies, such as long-acting injectables and Event-Driven Therapy, tailored to the east African context.

Thank you, Dr. Patel, for sharing your insights on lenacapavir and its potential to change the HIV treatment landscape in East Africa.

For more on lenacapavir and other HIV-related news, stay tuned to Archyde. We invite you to share your thoughts and questions on lenacapavir in the comments below.