Lenacapavir for the Treatment of Heavily Treatment-experienced People with Multi-class Resistant HIV

Abstract

Multidrug resistance to antiretroviral therapy, while uncommon, is associated with high rates of clinical progression and virologic failure. Lenacapavir is the first capsid inhibitor to be approved for the treatment of HIV infection in heavily treatment-experienced people with multi-resistant virus, who cannot be successfully treated with other available therapies due to resistance, intolerance or safety considerations. The key feature of lenacapavir is its long half-life, which allows its subcutaneous formulation to be administered every 6 months. This is crucial for a population with low adherence rates to antiretroviral therapy. This review discusses the characteristics of lenacapavir, including its mechanism of action, pharmacokinetics/pharmacodynamics and resistance profile, the key efficacy and safety data from clinical trials, and its place in the management of patients with multidrug-resistant HIV infection.