A Race Against Resistance

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Yale physician Onyema Ogbuagu has been involved in clinical trials for HIV for more than a decade. Trained as a medical student in Nigeria during the peak of the HIV epidemic there, Ogbuagu has seen HIV treatment evolve considerably over the course of his career. “At the time [I was trained], reversing immune deficiency was a dream,” Ogbuagu said. Nowadays, directly managing HIV is a real option. However, multidrug resistance and therapeutic regimen complexity remain notable barriers to treatment.

Ogbuagu published a landmark phase-three clinical trial testing the effectiveness of Lenacapavir, a recently FDA-approved HIV treatment. Administered as a biannual injection, Lenacapavir is the longest-acting antiviral agent that has been approved for HIV treatment. As an antiretroviral therapy, Lenacapavir interrupts viral replication of HIV in the body, slowing the progression of the disease, improving immune function, and reducing the risk of HIV transmission. The treatment is of particular interest for patients demonstrating multidrug resistance. 

Lenacapavir contributed to a virologic suppression rate of over eighty percent, much higher than the average virologic suppression rates observed in other multidrug-resistant trials. “[The trial] holds promise that we’re able to reach certain people that wouldn’t be successfully treated with [other] regimens,” Ogbuagu said. 

As this medication is being tested to treat HIV, Ogbuagu is also hopeful that HIV treatment options may evolve into a wide range of different methods and frequencies of delivery. “People could have the luxury of choosing a method that’s effective and that fits their lifestyle and their preferences,” he said. Ogbuagu’s study certainly brings his hopes of creating simpler, more effective therapeutic regimens to improve quality of life closer to reality.