The World Health Organization now recommends the use of Lenacapavir, preventive treatment against HIV. Administered under the skin, this medication represents a promising advance in the fight against the transmission of the virus.
In A press releaseWHO qualifies the “crucial” Lénacapavir in HIV prevention. This is the first preventive treatment injectable with prolonged action administered only twice a year.
“For the first time, we have an instrument that can change the course of the HIV epidemic,” said Peter Sands, executive director of the Global Fund for AIDS, Tuberculosis and Malaria (Global Fund). The announcement was made Thursday in Kigali, Rwanda, during the closure of the 13th conference of the International Society on AIDS.
A new course in prevention
“It is not just a medical advance, but also a political advance,” said in the RTS Forum program Alexandra Calmy, head of the HIV/AIDS unit at the Geneva University Hospitals (HUG). Because this official recognition by WHO opens the door to negotiated agreements, both with “the manufacturer and with generic producers who can now manufacture it,” she adds.
Lénacapavir is part of what is called prep, or pre-exhibition prophylaxis. It is a treatment intended for seronegative people but exposed to a risk of HIV infection. In Switzerland, the PREP is taken today in the form of daily tablets. Lénacapavir is an injectable version with prolonged action, which would only require an injection every six months.
For Alexandra Calmy, the new treatment represents a major advance: “It is not a vaccine, but it is in any case the solution closest to a vaccine that we have never had.”
The vaccine, a horizon still to be achieved
Since Lenacapavir acts as a chemical barrier and not as a stimulant of the immune system, its protection is less durable. This is why, according to Alexandra Calmy, “it is worth continuing research: a vaccine is not the same thing”.
“The vaccine could have a more sustainable and broader public health impact. Once administered, it protects for several years. It is therefore no longer necessary to permanently seek people at risk to offer them treatment,” she said.
A promising treatment, but at what price?
Alexandra Calmy calls for Switzerland, as well as the countries most affected by HIV, to negotiate access to the Lénacapavir. Not because the molecule is more powerful, but because it reduces the risk of forgetting. An injection every six months is enough, where the oral prep requires a daily intake. “We take it twice a year and then we no longer have to worry about it,” said the scientist.
The price of the new treatment, the Lenacapavir, will nevertheless raise several questions. In the United States, its cost amounts to 28,000 dollars per year and per patient, an amount that contrasts strongly with that of the oral prep currently available in Switzerland, which costs around 70 francs per month.
Interview by Mehmet Gultas and Julien Bangerter
Adaptation web: Miroslav Mares