After more than four decades of research and treatment advances, a new drug presents a promising contribution to the fight against HIV/AIDS. Developed by Gilead Sciences, lenacapavir offers hope for people with limited treatment options due to drug-resistant HIV.
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History and reach
An estimated 1.3 million people are infected with HIV each year, but with the recent approval of lenacapavir under the brand name Yeztugo by the U.S. Food and Drug Administration, this number could see drastic changes. HIV affects the body’s immune system, and without treatment, the virus can lead to AIDS.
HIV was first detected in the U.S. in 1981, taking the lives of more than 700,000 Americans since, according to the Centers for Disease Control and Prevention.
In Ohio, the number of HIV/AIDS diagnoses sharply peaked in the early 1990s, and since then has slowly declined. Ohio saw 861 new cases reported in 2023, with the majority of cases reported in Franklin County.
One early treatment for the disease was antiretroviral therapy, an assortment of daily pills designed to contain the virus. Since then, antiretroviral therapy has become a widely used daily treatment for those with HIV, working to protect others from contracting the virus. Lenacapavir began as a treatment used in combination with other medicines for HIV-positive patients, but has recently been approved as a preventative measure against the spread of the virus.
How it works
Most HIV drugs focus on suppressing the virus within the body to prevent the spread to others through daily pills. Due to the high dependence on consistency with the daily medication, the effectiveness of these pills is not as high as it could be. Lenacapavir, which is administered as a biannual injection, offers a solution that doesn’t depend on a strict daily schedule.
Like a vaccine, lenacapavir works to prevent infection before the virus enters the body. Unlike a vaccine, however, lenacapavir stays in the body as a defense against HIV, while vaccines train the immune system to fight off sickness.
According to Time Magazine, lenacapavir stays in the body longer than other antiviral medications and has proven to be effective in preventing the replication process of the virus.
Potential for impact
Lenacapavir has demonstrated a roughly 99.9 percent protection rate in a large clinical trial. The treatment works by preventing the spread of the virus, so the drug would be administered to those who are HIV-negative. For those already living with HIV, lenacapavir can be used in combination with other treatments to control the spread of the virus in the body.
While lenacapavir holds potential to have a strong impact on the spread of HIV, accessibility is a key concern. As of now, only medical professionals can administer the injections, making access more difficult for vulnerable populations in low- and middle-income countries.
In the U.S., the annual list price for lenacapavir as HIV prevention (Yeztugo) is more than $28,000. By contrast, generic versions licensed for use in low- and middle-income countries are priced at about $40 per year, with estimates suggesting the cost could drop to roughly $25 per year if demand is high.
The cost agreement is backed by Unitaid, an organization dedicated to providing affordable and accessible healthcare across the world. The treatment was quickly approved by the FDA and European Medicines Agency, and is set to be accessible in low- and middle-income countries by 2027.
Ali Hartzell is an editorial assistant at CityScene Media Group. Feedback welcome at feedback@cityscenemediagroup.com.
