Why A Single Drug Could Change Everything For HIV And AIDS
CHENGDU, CHINA - DECEMBER 1: (CHINA OUT) A migrant worker wears a red ribbon during an event ... More organized by the local government to promote HIV/AIDS knowledge among migrant workers . (Photo by)
A twice-yearly injection of a drug known as Sunlenca offered 100% protection against HIV among young women and girls in South Africa and Uganda, according to research published in the New England Journal of Medicine.
Over 5,000 girls participated in the study, with participants receiving either the twice-yearly shot or an oral pill for HIV prevention. Of those receiving the oral pill, 2% eventually acquired HIV from infected sex partners. The study did not examine what the effect of Sunlenca would be on men.
The twice-yearly shot is manufactured by U.S. drug maker Gilead and is sold as Sunlenca (Lenacapavir), but only to treat HIV, not prevent it. If found to prevent HIV infection with 100% efficacy in men too, the drug could be a huge game-changer for HIV and AIDS. Here is why.
The drug operates differently from most HIV medications that usually target enzymes. Sunlenca, on the other hand, targets the HIV capsid which is a protein shell that encases the virus's genetic material. This allows the drug to interfere with multiple stages of the HIV life cycle, including but not limited to the virus's ability to assemble new viral particles, replicate and enter cells. This unique mechanism of action plays a huge role in its success to prevent the HIV virus from proliferating in a person's body.
The drug is also long-acting and is injected as opposed to taken orally. This has many advantages, since taking daily oral pills can be difficult for most patients. In one study, the median rate of compliance in taking an oral pill for HIV pre-exposure prophylaxis among men was just about 64%, highlighting a major barrier in HIV prevention. Many patients on drugs for any reason struggle with the burden of taking daily pills, leading to missed doses and suboptimal treatment for their specific disease. Sunlenca's twice-yearly dose regimen eases compliance to treatment and could potentially lead to very low if not zero rates of HIV infection in the future if it were ever recommended for prevention.
Sunlenca also has the potential to mitigate the stigma and psychological toll of patients that have or may be at high risk of getting HIV. Taking daily oral pills to treat or prevent HIV can act as a constant reminder of HIV for an individual, a viral infection acquired primarily through sexual contact or sharing of needles. HIV stigma refers to the negative beliefs and attitudes regarding people with HIV, which include but are not limited to judging people who are taking steps to prevent HIV or treating them differently. A twice-yearly injection can reduce this stigma, allowing people to live more normal lives without the constant reminder of their HIV status.
Finally, Sunlenca can have broader implications for public health. Globally, there are approximately 40 million people living with HIV, according to Kaiser Family Foundation. Imagine a world where people can take an injection once every six months, and not worry about ever contracting the virus. This could be a reality if Sunlenca is shown to prevent HIV in a broader population, as it already has shown to be 100% effective among young girls in South Africa and Uganda.
Although more thorough research and testing will be needed, Sunlenca could be a game-changer for HIV prevention. It offers a much needed hope for the millions around the world who could potentially prevent getting HIV altogether.
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