開啟HIV預防的新世代──Lenacapavir

隨著藥物研發進步，首款衣殼蛋白抑制劑（Capsid inhibitor）Lenacapavir為HIV治療與預防開啟新篇章。它藉由干擾病毒生命週期的多個關鍵階段，發揮獨特的抗病毒效果。PURPOSE 1及2試驗結果指出，Lenacapavir作為長效暴露前預防用藥（Pre-exposure prophylaxis，PrEP）能大幅降低感染率，且為難以堅持每日口服PrEP藥物的族群提供了新的預防方案。儘管其具備終結疫情的潛力，未來在普及應用時，仍需密切監測相關抗藥位點對整體防治的影響。

As a first-in-class HIV-1 capsid inhibitor, lenacapavir is characterized by a unique antiviral mechanism, which entails interference with multiple stages of the viral life cycle. On the basis of data obtained from two Phase 3 clinical trials (PURPOSE 1 and 2), it was established that compared with daily oral PrEP, long-acting injectable lenacapavir PrEP demonstrated superior efficacy in preventing HIV infection, with no new safety concerns identified. A twice-yearly PrEP option contributes to addressing the challenges associated with adherence to and persistence with daily oral regimens. However, despite its promise in bringing an end to the HIV epidemic, widespread adoption must be accompanied by close surveillance of resistance-associated mutations (RAMs) and their impact on future therapeutic options.