A study by Weill Cornell Medicine indicates that lenacapavir, a new HIV therapy, has low resistance in Ugandan patients. With only 1.6% showing resistance mutations, lenacapavir is expected to be effective against local strains. This drug could be a crucial tool against HIV as it disrupts the virus’s ability to reproduce, requiring bi-annual treatment for patients. The findings emphasize the need for ongoing research in underrepresented communities.
A recent multinational study led by Weill Cornell Medicine has revealed minimal natural resistance to lenacapavir, a novel HIV therapy, among Ugandan patients. The findings, published on January 30 in the Journal of Antimicrobial Chemotherapy, suggest lenacapavir could be a critical addition to HIV treatment options available globally. In Uganda, approximately 1.5 million individuals are living with HIV.
Senior author Guinevere Lee, an assistant professor of virology, stated, “Our data shows that only 1.6% of the individuals studied are living with HIV strains that have any known lenacapavir-associated resistance mutations.” This indicates that lenacapavir is likely effective against prevalent HIV strains in East Africa, a significant finding given the regional context of HIV management.
Since the 1990s, antiretroviral drug combinations have significantly reduced HIV viral loads in patients. However, the challenge of drug resistance continues as the virus adapts to existing therapies. Lenacapavir stands out as it uniquely disrupts the capsid layer that protects HIV’s RNA, inhibiting its replication and transmission.
This drug requires bi-annual treatment and has proven effective not only for treatment-naïve patients but also for those with drug-resistant HIV strains. Clinical trials last year demonstrated lenacapavir’s efficacy, showing 100% success in preventing HIV infections among HIV-negative women in sub-Saharan Africa.
Research pertaining to lenacapavir’s effectiveness against less-studied HIV-1 variants like subtypes A1 and D has been limited. These subtypes are prevalent in Eastern and Southern Africa compared to subtype B, common in Europe and the U.S., which rarely shows resistance mutations.
This study, conducted alongside collaborators from Mbarara University and Massachusetts General Hospital, involved sequencing capsid proteins from 546 HIV-1 subtype A1 and D samples collected from Ugandan patients never exposed to antiretroviral therapy.
Results indicated that none of the participants possessed major genetic mutations conferring lenacapavir resistance. A small fraction—nine patients—exhibited minor mutations that could slightly diminish efficacy, but these were insufficient to cause full drug resistance.
Lee remarked, “Our study supports lenacapavir’s potential efficacy in this region. As lenacapavir is rolled out in East Africa, further studies will need to monitor for the emergence of drug-resistant strains.” They emphasized the need for HIV research to reach regions with distinct viral patterns.
The research received funding from the National Institutes of Health, indicating strong institutional support for such critical health initiatives.
The findings from the study highlight the potential effectiveness of lenacapavir for HIV treatment in Uganda, demonstrating minimal resistance and promising results in preventing infections. Continued monitoring for drug resistance is vital as lenacapavir becomes more widely used. The study underscores the importance of further research in regions with unique HIV strains to optimize treatment strategies.
Original Source: news.cornell.edu
