Lenacapavir (LEN), a twice-yearly injectable long-acting capsid inhibitor used in combination with an optimized background regimen, is indicated for heavily treatment-experienced adults with multi-drug-resistant HIV-1 infection. From the US Observational Pharmaco-Epidemiology Research & Analysis (OPERA) cohort, 116 adults with HIV with ≥1 set of LEN injections were included [baseline viral load (VL) 28 weeks after the prior set). The median delay was 11 days past the injection window (interquartile range: 4, 118). At study end, 91% remained on a LEN-containing regimen. In this cohort representative of routine clinical care in the United States, factors other than virologic control may be driving the decision to start LEN (e.g., safety, tolerability, resistance, simplification). Most people experienced favorable virologic outcomes and good adherence to LEN, which may serve as an effective option for those who could benefit from a long-acting injectable agent from a novel ARV class.
Mounzer et al. (Sat,) studied this question.