Linking To And Excerpting From “Six-Month HIV Prevention Shot Achieves 99% Efficacy in Major Study” By Emory Health Sciences

For a complete set of resources on HIV diagnosis, treatment, and prevention, please see CDC HIV Nexus: CDC Resources for Clinicians.

Today, I review, link to, and excerpt from Six-Month HIV Prevention Shot Achieves 99% Efficacy in Major Study by Emory Health Sciences from SciTechDaily, December 2, 2024.

All that follows is from the above resource.

Lenacapavir, a new twice-yearly injection, offers 96% HIV prevention efficacy, surpassing daily oral PrEP.

For oral medications that prevent new HIV infections to be effective, patients must take specific steps, such as attending doctor’s visits every three months and, most importantly, maintaining consistent use.

These daily oral antiretrovirals, more commonly referred to as PrEP (pre-exposure prophylaxis), such as Truvada®, are extremely effective at HIV prevention, but only if they are taken daily as directed. Truvada’s efficacy is greatly compromised when taken inconsistently.

However, results from a recent Gilead-funded clinical trial (Purpose-2) led by physicians at Emory University and Grady Health System indicate that a twice-yearly injection of Lenacapavir offers a 96% reduced risk of infection overall, making the injection significantly more effective than the daily oral PrEP. The findings were recently published in the New England Journal of Medicine.*

*Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons [PubMed Abstract]. N Engl J Med. 2024 Nov 27. doi: 10.1056/NEJMoa2411858. Online ahead of print.

Seeing these high levels of efficacy – at almost 100% — in an injectable that people only have to take every six months is incredible,” says Colleen Kelley, MD, lead author of the study and professor in the School of Medicine at Emory University. “This is a considerable and profound advancement in medicine, especially for people whose circumstances don’t allow them to take a daily oral medication, and for those among populations disproportionately impacted by HIV.”

Efficacy and Adherence: Injectable vs. Oral PrEP

In the randomized, double-blind, Phase III clinical trial comparing the efficacy of the two medications, 99% of the participants in the Lenacapavir group did not acquire an HIV infection. During the trial, only two participants in the Lenacapavir group, comprised of 2,179 people, acquired HIV. This compares to nine new HIV infections in the Truvada®group, which had 1,086 people. The trial showed that adherence to the injectable was higher than of the daily oral pill.

Kelley, also the co-director of the Emory Center for AIDS Research, and Associate Dean for Research for Emory at Grady adds that while PrEP is incredibly effective at preventing infection, part of what made the injection more effective in the clinical trial was the challenges associated with adherence to a daily oral pill.

“What we see over time is that about half of people who start taking daily oral PrEP stop within a year due to various factors,” says Kelley, referencing healthcare disparities in general. “Having an effective injectable that is only needed twice annually is very significant for people who have trouble accessing healthcare or staying adherent to daily, oral pills.”

“The results of this study add to the armamentarium of novel tools for HIV prevention. Long-acting antiretrovirals offer new hope for those who are not able to take oral medications,” says Carlos del Rio, MD, chair of the Department of Medicine at Emory University School of Medicine. “The challenge is now to roll out and make these tools available and accessible in an equitable way— only then we will see new HIV infections dramatically decreased locally and globally,” adds del Rio, also co-director of the Emory Center for AIDS Research.