NHS Rolls Out 'Trailblazing' Lenacapavir for Multi-Drug-Resistant HIV
核心洞察
NHS England (搜索) will make lenacapavir, a first-of-its-kind capsid-targeting drug, available to patients with HIV (搜索) resistant to all other antiretroviral medications.
The treatment offers a novel mechanism of action, targeting the virus's protective capsid rather than the enzymes targeted by existing drugs.
Around 92 eligible patients will be contacted initially, with an estimated 300 people expected to receive the treatment within three years.
NHS England (搜索) has announced that a "trailblazing" new treatment for multi-drug-resistant HIV (搜索) will be made available on the NHS for the first time, following a recommendation from the Clinical Priorities Advisory Group. The drug, lenacapavir, will offer a lifeline to hundreds of people in the UK living with a rare mutation of HIV that is resistant to all other antiviral medications.
While existing antiretroviral treatments work for most people with HIV (搜索) to achieve undetectable viral loads and live long, healthy lives, a small number of patients do not respond to them. Lenacapavir represents a first-of-its-kind approach, working by targeting the virus's protective outer capsid to prevent it from reproducing. This novel mechanism differs from conventional treatments, which are usually tackled through enzyme inhibitors.
A Novel Mechanism of Action
Lenacapavir targets the virus's protective outer shell, known as the capsid, preventing it from reproducing. Up until now, existing NHS drugs have targeted the enzymes that HIV (搜索) uses to make copies of itself. This new approach offers hope to those facing serious illness and death from a previously untreatable form of the disease.
The treatment also helps reduce the viral load in patients so they are unable to pass the virus on to others. Administered through a combination of oral and injectable doses, patients first start treatment by taking a tablet for two days, another tablet eight days later, followed by two injections on day 15. After initial treatment, patients only need to receive a maintenance dose through an injection bi-annually, making it much more convenient than some other treatments currently available to HIV (搜索) patients.
Patient Impact and Rollout
There are currently around 100,000 people in England living with HIV (搜索). Although there is no definitive cure for the disease, the majority of those affected are now able to lead normal, long and healthy lives. However, for a minority, the virus has mutated to become resistant to standard antiretroviral drugs, allowing it to progress to life-threatening illness.
The NHS estimates that within the next three years, the treatment could be available to 300 people in England, and it is already contacting those eligible to receive their first dose as soon as possible. Around 92 eligible patients in England will initially be contacted over the next few weeks to inform them that they qualify for lenacapavir. One in ten of all new HIV (搜索) diagnoses in the UK involve a virus with some level of drug resistance to antiretroviral drugs, and around 100 people a year in England are likely to need lenacapavir because they have become resistant to all medications.
One woman, who asked to be referred to only as Jane, told how she was born with HIV (搜索) infection and prescribed multiple different medications throughout childhood. She developed a fear of swallowing large tablets and eventually resistance to first-line HIV treatments. Before accessing lenacapavir via a compassionate access programme with the drugmaker, her immune system was dangerously low, and she was admitted to hospital regularly with complications. Following treatment, she now has undetectable HIV levels and her immune system has recovered.
Jane said: "Lenacapavir has been life saving for me. Before this medication, I was really unwell. Now I am working full time and am living a normal life. I'm not worried anymore and feel a lot happier. I'm so pleased that more people living with HIV (搜索) that is resistant to treatment will now be able to get this treatment from the NHS. It can make all the difference."
Eliminating HIV Transmission by 2030
Today's announcement is part of a wider plan to eliminate the spread of HIV (搜索) in England by 2030, which also includes initiatives such as opt-out testing in A&E departments, easily available at-home testing kits that can be ordered on the NHS App, and a national programme to re-engage people back into life-saving HIV care and treatment.
John Stewart, National Director for Specialised Commissioning at NHS England (搜索), said: "This trailblazing drug will offer a lifeline to people living with HIV (搜索) for whom conventional treatments have not worked and options are currently limited – giving them the opportunity to live a normal, healthy and long life. It's fantastic news that this treatment will offer fresh hope to hundreds of patients going forward and help transform HIV into a manageable condition for them."
Health Minister Baroness Merron said: "For people living with drug-resistant HIV (搜索) this landmark treatment will totally transform their lives and, even better, it's available on the NHS. We're determined to end new HIV transmissions by 2030 and this life-saving drug alongside our new HIV Action Plan, demonstrates this government's commitment to give people living with HIV every opportunity to live long and healthy lives."
Daniel Fluskey, director at the National AIDS (搜索) Trust, said: "This is a huge decision for people who need life-saving treatment and takes us a step closer to ensuring that no one dies from AIDS-related illnesses here in the UK. Over years too many people have lost loved ones, family, and friends because of a lack of access to medicine and the harm caused by stigma, prejudice, and discrimination. So when a new life-saving treatment is available it must get to the people who need it."
Fluskey added: "We've come so far with HIV (搜索) treatment that people can now expect to live long and healthy lives with HIV, and alongside improvements in HIV prevention we have all the tools needed to achieve the UK Government's goal of ending new HIV transmissions and AIDS (搜索)-related deaths by 2030, as long as those tools can be easily accessed by everyone who needs them."
Despite huge strides made to reduce global HIV (搜索) rates and AIDS (搜索)-related deaths since 2000, about 1.3 million people still contracted HIV last year, and more than 600,000 people died from AIDS-related illnesses.