Breakthrough in research? Six-monthly injections prevent HIV infection-Therapies enable a largely normal life, and an infection no longer means an end: many people become infected with HIV every year. A new vaccination could mean a breakthrough – but the goal remains to avoid infections.
Breakthrough in research? Six-monthly injections prevent HIV infection
Munich. According to researchers, a drug injected every six months can reliably prevent HIV infection. The study, which was published in the “New England Journal of Medicine” (NEJM) and presented at the World AIDS Conference in Munich, raises great hopes in the fight against AIDS.
The study involved around 5,338 girls and young women in South Africa and Uganda who were initially HIV infection negative. There was not a single infection among the 2,134 participants who received lenacapavir injected under the skin twice a year. In the other two groups with around 3,200 participants who took two different medications for pre-exposure prophylaxis (PrEP), there were a total of 55 HIV infections.
Groundbreaking progress
Lenacapavir was 100 percent effective, said study lead author and director of the Desmond Tutu HIV infection Center at the University of Cape Town Linda-Gail Bekker to applause from the audience at the AIDS Conference, the world’s largest scientific meeting on HIV infection. Sharon Lewin, President of the International AIDS Society (IAS), spoke of groundbreaking progress.
The other drug cabotegravir, which is approved for the treatment of people living with HIV infection and also for PrEP in Europe, protects against infection for around eight weeks. There was a study in rural Uganda and Kenya on its feasibility among men and women in Africa, which showed that many preferred the injection simply because they were worried about forgetting to take the tablets.
UNAIDS Executive Director Winnie Byanyima spoke of miracle cures. She specifically called on Gilead to do everything possible to make lenacapavir available quickly and inexpensively to people, especially in Asia, Latin America and Africa. There is no time to lose. Byanyima referred to the UN goal of no longer viewing HIV infection as a threat to public health by 2030. That’s another six years – but 1.3 million people worldwide are still infected with the virus every year, and one person dies every minute as a result of AIDS.
Jared Baeten, senior vice president of clinical development at Gilead Science, reported that a second study is already underway with men, including trans people as a group particularly affected by HIV infection. The results are expected at the end of this year. Approval of lenacapavir as pre-exposure prophylaxis in many countries could be possible by the end of 2025. Gilead is already in discussions with generic drug manufacturers. However, it must be ensured that the drug is produced in high quality.
Price not yet estimated
Baeten said he couldn’t give a price at the moment. However, Gilead is striving to make lenacapavir available as quickly as possible at a reasonable price, especially in countries with high HIV incidence and few resources. The price quoted by activists for lencapavir in the US of $40,000 for an annual treatment only affects certain patients and will not apply to future prophylaxis.
“This is music to my ears,” commented Byanyima on the statements. She recalled how quickly the Covid-19 vaccination could be made available and demanded: “Move quickly.” Shareholder value should not be the focus.
On the sidelines of the World AIDS Conference, activists demonstrated for the provision of generic drugs. If mass produced, they could cost $100 a year, or possibly as little as $40, argue activists and researchers at the University of Liverpool. The debate about the high development costs of pharmaceutical companies for medicines and the debate as to whether these companies still provide their development for cheap generics is a recurring topic.
Alternative to vaccination?
Research into a vaccination continues worldwide. However, prophylaxis with lenacapavir is – provided the 100 percent effectiveness is confirmed in the long term – more effective than one could have expected from vaccinations, said the local congress president Christoph Spinner, an infectiologist at the Rechts der Isar Clinic at the Technical University of Munich.
Young women in Africa in particular, as a group particularly affected by HIV infection, could benefit from long-acting prevention via injection, emphasized researcher Bekker. According to UNAIDS, 4,000 young women are infected every week worldwide, more than 3,000 of them in sub-Saharan Africa. In some cases, women are discriminated against because they take the previously common daily oral pre-exposure prophylaxis with pills, for example because it is assumed that they are already infected.