Lenacapavir for Treating Multidrug-Resistant HIV-1

Lenacapavir, a first-in-class inhibitor of HIV-1 capsid function, has activity against viruses with mutations conferring resistance to commonly used antiretroviral agents. It can also be administered as a long-acting agent, with subcutaneous (SQ) injections every 6 months. In this phase 3 study, investigators assessed lenacapavir's efficacy and safety in patients on a failing regimen who had resistance to at least two antiretrovirals. In all, 72 patients (median age, 52; 25% female; 38% Black; median viral load, 4.5 log₁₀ copies/mL; 62% with CD4 <200 cells/mL) were categorized according to change in HIV-1 viral load between screening and cohort selection.

The 36 participants in cohort 1 had stable viremia with HIV-1 ≥400 copies/mL and were r…