A New Treatment for HIV is on the Horizon

Breakthrough drug lenacapavir has shown to be 100 % effective for preventing HIV when administered twice a year, according to a research article published in the New England Journal of Medicine.

The study, called PURPOSE 1, was a randomized trial of over five thousand cisgender women in South Africa and Uganda, where lenacapavir was administered to just under half of the participants at a biyearly interval (every 26 weeks).

The other group received two different forms of pre-exposure prophylaxis, commonly known as PReP, instead. The group receiving PReP reported a combined 55 infections, whereas the group receiving lenacapavir reported zero.

“These stellar results show that twice-yearly lenacapavir for PrEP, if approved, could offer a highly effective, tolerable, and discreet choice that could potentially improve PrEP uptake and persistence, helping us to reduce HIV in cisgender women globally,” says Linda-Gail Bekker, director of the Desmond Tutu HIV Center at the University of Capetown. This wording is somewhat problematic, as trans women have been proven to be at a higher risk for HIV due to a lack of accessible treatment stemming from discrimination.

The results of the PURPOSE 1 trial were showcased at the 2024 International AIDS Conference in Munich, where it was dubbed a “game-changing” measure in the fight against HIV and AIDS, according to the Harvard Gazette. The kicker with the already-available drug, marketed as Sunlenca, is that it costs $42,000 for one year of treatment alone. Thus, distribution to low-resource countries in a “high-quality, low-cost” program is necessary to truly advance the treatment of HIV worldwide.

Representatives at Gilead Sciences, the company that developed lenacapavir, have formed an access strategy for distributing the drug to countries with higher rates of HIV infection at a low cost. At the International AIDS Conference, the idea of the drug being reduced to $40 per treatment and still making a 30% profit was pitched to make it more accessible as well.

However, Gilead isn’t all sunshine and roses—The biotech giant has been under pressure from both the legal system as well as the activist community for some shady dealings when it comes to the treatment of HIV. In 2023, the United States government lost their case against Gilead in which they accused the company of using CDC research to sell a marketed TDF product, Truvada, at the unreasonable price of  $2,000 a month.

In this case, it was ruled by the California First District Court of Appeals that the company was pushing back the development of other HIV treatments on its plate to continue profiting off of Truvada sales, a cause which activists from the AIDS Healthcare Foundation also rallied against. Gilead settled the legal complaints lodged against them with a $40 million dollar settlement in June.