Although lots of lifesaving antiretroviral treatments have emerged, HIV to AIDS-related illnesses has cost the lives of 690,000 people in 2020. More than 10 million (27%) of the 37.6 million people are living with HIV and are not on treatment even today.
Moreover, “we are getting signals of HIV drug resistance, which means we need to strengthen our surveillance efforts and continue to invest in long-acting prevention and treatment tools, in the absence of an HIV vaccine, and also remember that solutions we find may not be one size that fits all”, says Dr. Adeeba Kamarulzaman, President of the International AIDS Society (IAS), during the closing session of the 11th International IAS Conference on HIV Science (IAS 2021).
Drug in the Pipeline
The session had stressed the need for developing new treatment options for people living with HIV, especially for those with resistance to drugs. This included data of three key phase-3 studies – FLAIR, ATLAS, and ATLAS 2M for testing the efficacy of long-acting drugs for HIV.
The long-acting drugs include 2-monthly injectable – Rilpivirine (a non-nucleoside reverse transcriptase inhibitor) and Cabotegravir (an integrase inhibitor) for maintenance of viral load suppression.
The regimen was found to be safe, well-tolerated with very high patient satisfaction. The drugs can be used by those people living with HIV who are on oral antiretroviral therapy.
It has already been approved and licensed for use in the European Union (EU) and the USA. However, due to the lack of clinical data for pregnant women, they are excluded from using these injectables.
Another phase-2b study evaluated the safety and efficacy of Islatravir/ Doravirine that showed the maintenance of viral suppression in 90% of the participants. This shows that the drug combination is a potent two-drug regimen that works as well as a standard three-drug regimen.
The other drugs in the pipeline with potent efficacy include Lenacapavir (potent capsid protein inhibitor), the combination of Lenacapavir and Islatravir, and Maturation Inhibitors (GSK254 and GSK937).
The session also shared recent updates on various ongoing HIV vaccine efficacy studies that include Imbokodo Phase 2b (HVTN 705) and, Mosaico Phase 3 (HVTN 706) study.
Lot of long-acting treatment options for HIV are currently under different stages of development. This could potentially have a very positive impact on advancing progress on ending AIDS.