Breaking News in HIV Treatment

A groundbreaking HIV prevention drug, lenacapavir, is on the verge of approval in the US, sparking hopes of curbing the HIV pandemic. However, campaigners are raising concerns about its affordability, urging manufacturer Gilead to make it accessible to all who need it.

The Promise of Lenacapavir

Lenacapavir has shown 100% efficacy in preventing HIV acquisition in clinical trials, making it a game-changer in HIV prevention. This twice-yearly injectable medication could revolutionize the fight against HIV, especially in low-income countries where access to antiretroviral therapy is limited.

Pricing Concerns

The current price tag for lenacapavir is a staggering $42,250-$44,819 per year, which campaigners argue is unaffordable for most people living with HIV. However, a recent study suggests that lenacapavir could be produced for as low as $40-$100 per person per year, a 1,000-fold reduction in price.

Call to Action

Activists and advocacy groups, including Médecins Sans Frontières (MSF) and Health GAP, are calling on Gilead to make lenacapavir affordable for all. They urge the company to license the drug to generic manufacturers through the Medicines Patent Pool, allowing for mass production and distribution in low- and middle-income countries.¹ ²

Global Access

Gilead’s voluntary licensing agreement for lenacapavir has been criticized for excluding key regions where HIV is prevalent. Campaigners are pushing for a more inclusive approach, ensuring that lenacapavir reaches those who need it most, particularly in low-income countries where HIV incidence is high.

The Future of HIV Prevention

Lenacapavir’s approval and accessibility could mark a significant turning point in the fight against HIV. With its potential to prevent millions of new infections, it’s crucial that this medication is made available and affordable for all who need it. The global health community is watching closely, hoping that Gilead and regulatory bodies will prioritize accessibility and affordability in the rollout of lenacapavir.³

Mechanism of Action Of Lenacapavir

Lenacapavir is a first-in-class HIV-1 capsid inhibitor that disrupts multiple stages of the viral life cycle by targeting the HIV-1 capsid protein. Specifically, it binds to the capsid protein subunits, disrupting their interactions and interfering with capsid-mediated nuclear uptake of proviral DNA, virus assembly and release, and capsid core formation. This leads to the production of malformed capsids that cannot replicate effectively. 

Here’s a more detailed breakdown: 

• Targeting the HIV-1 Capsid:Lenacapavir directly binds to the HIV-1 capsid protein (p24) subunits within hexamers, crucial for capsid structure and function.
• Interfering with Viral Replication:By binding to the capsid, lenacapavir disrupts several key steps in the HIV-1 replication cycle:
  • Nuclear Uptake: It impairs the capsid’s ability to transport the viral DNA into the cell’s nucleus, a critical step for integration into the host genome.
  • Virus Assembly and Release: It interferes with the proper assembly and release of new viral particles.
  • Capsid Core Formation: It disrupts the formation of the capsid core, the protective structure that surrounds the viral genetic material.
• Impaired Viral Replication:The overall effect of lenacapavir’s action is the production of defective viral particles with malformed capsids that are unable to replicate effectively in new host cells.

In essence, lenacapavir acts as a “hinge” on the capsid protein, preventing it from performing its essential functions during the viral life cycle according to a YouTube video. This unique mechanism of action makes lenacapavir a promising new approach for treating HIV-1, particularly in cases where other antiretroviral therapies are not effective.