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A vaccine-like drug administered once a year to prevent HIV could be ready just after 2030, according to drugmaker ViiV, transforming management of a virus that has killed nearly 40 million people in an epidemic that has lasted more than four decades.
While there is no vaccine to treat HIV, a virus that can lead to Aids, pre-exposure prophylaxis (PrEP) has reduced transmission rates by offering protection to those at risk of exposure. Most PrEP therapies involve daily oral medications or taking medication before engaging in unprotected sex. However, the emergence of a prevention drug similar to a vaccine could significantly lessen the burden on patients and global health authorities.
ViiV, an HIV drug developer, is fast-tracking research on VH184, an antiretroviral drug designed to hinder the action of the integrase enzyme, which inserts the HIV virus’s genetic code into the host cell’s DNA.
Kimberly Smith, head of research and development at ViiV, believes that a long-acting drug, administered annually, will be achievable in the near future. She stated, “I can’t say when, but not too far beyond the end of this decade. It will be possible, I believe.”
Smith explained that VH184 has shown a prolonged half-life in pre-clinical studies and the next step is to determine if this translates to humans.
Long-acting drugs are administered intramuscularly on a monthly or less frequent basis, releasing chemicals gradually over an extended period. Meg Doherty, head of the HIV program at the World Health Organization, finds ViiV’s long-acting drug pipeline exciting, but emphasizes the importance of ensuring affordable and universal coverage.
ViiV, a majority-owned venture of GSK with partners Pfizer and Shionogi, recently raised its sales growth projection thanks to its investment in long-acting drugs. This investment helps offset the loss of exclusivity for its blockbuster oral treatment, dolutegravir.
ViiV already has two approved long-acting drugs — Cabenuva, used in combination with another molecule to treat HIV patients, and Apretude, a PrEP medication. These non-oral products are typically taken monthly or every two months.
Deborah Waterhouse, ViiV’s CEO, notes the high adoption rate of long-acting PrEP drugs in the US, but the situation is mixed in the EU due to individual country negotiations for reimbursement. While some governments have shown interest, others have not placed orders as they have been able to manage HIV caseloads with more affordable oral treatments.
Access to long-acting drugs in low-income countries with high HIV rates remains inconsistent, despite generic manufacturing licenses. Médecins Sans Frontières refused to sign a non-disclosure agreement requested by ViiV for an access deal in Mozambique and other countries.
ViiV is aiming to reach a resolution with Médecins Sans Frontières and ensure wider access to long-acting drugs for prevention in Africa, where the burden of HIV is highest.
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