Lenacapavir, a long-acting HIV capsid inhibitor, continues to show promise both for treatment-experienced people and those new to antiretroviral therapy. The CAPELLA trial enrolled people with extensive drug resistance who were currently on treatment but unable to maintain viral suppression. They started on lenacapavir pills and then switched to injections every six months plus an optimized back-ground regimen. At 52 weeks, 83% had a viral load below 50, and CD4 counts rose by an average of 83 cells. The CALIBRATE trial enrolled previously untreated participants who were randomized to receive oral or injectable lenacapavir plus tenofovir alafenamide/emtricitabine (Descovy) or a standard three-drug regimen. At 54 weeks, 85% to 90% of lenacapavir recipients had an undetectable viral load. The Food and Drug Administration has put a clinical hold on lenacapavir due to concerns about the glass vials used for the injectable formulation; drugmaker Gilead Sciences is working to resolve the problem.
They started on lenacapavir pills and then switched to injections every six months plus an optimized back-ground regimen.