New HIV Therapy Lenacapavir Promises Effectiveness in Uganda

A study from Weill Cornell Medicine indicates that lenacapavir, a new HIV therapy, shows minimal resistance in Ugandan patients. The research highlights the drug’s promise in treating prevalent strains of HIV in East Africa, with findings revealing low levels of resistance mutations. Continued monitoring for drug resistance is necessary as the therapy is rolled out in the region.

A recent multinational study spearheaded by Weill Cornell Medicine has demonstrated minimal natural resistance to lenacapavir, a new HIV therapy, within a Ugandan patient population. The findings, published in the Journal of Antimicrobial Chemotherapy, suggest that lenacapavir could be a significant addition to HIV treatment options. Currently, around 1.5 million individuals in Uganda are living with HIV.

Senior author Guinevere Lee, an assistant professor of virology at Weill Cornell Medicine, noted that only 1.6% of the participants exhibited known lenacapavir-related resistance mutations. This statistic highlights the drug’s potential effectiveness against prevalent HIV strains in East Africa. Since the 1990s, combination therapies have reduced virus loads to undetectable levels, yet evolving drug resistance remains a challenge.

Lenacapavir uniquely targets the protective capsid surrounding the HIV genetic material, inhibiting the virus’s ability to replicate and spread. Biannual treatments of lenacapavir have shown promise in patients, including those with resistant HIV strains. Recent clinical trials indicated complete efficacy in preventing HIV infection among HIV-negative women in sub-Saharan Africa.

Limited research had previously been conducted on pre-existing resistance to lenacapavir among less-studied strains like subtypes A1 and D, common in Eastern and Southern Africa. Unlike subtype B strains, prevalent in Europe and the United States, these strains rarely exhibit mutations imparting lenacapavir resistance. The research team at Mbarara University of Science and Technology and Massachusetts General Hospital sequenced capsid proteins from HIV-1 subtypes A1 and D in 546 Ugandan patients who had never undergone antiretroviral therapy, thereby investigating naturally circulating viral variants.

The researchers revealed no significant genetic mutations associated with major lenacapavir resistance among participants. Minor mutations affecting lenacapavir efficacy were noted in only nine patients, but these would not prevent the drug’s effectiveness. Lee affirmed, “Our study supports lenacapavir’s potential efficacy in this region.” Monitoring for emerging drug-resistant strains will be crucial as lenacapavir is implemented in East Africa.

The recent study indicates that lenacapavir presents a promising new treatment option for HIV in Uganda, with minimal natural resistance detected among local strains. This research underscores the importance of continued surveillance for drug-resistant strains as the therapy is introduced into the region. Ensuring that HIV research includes diverse populations is vital for the successful management of the virus globally.

Original Source: news.cornell.edu