Lenacapavir in HIV prevention care: What the pharmacist should know

Abstract

Despite advances in antiretroviral therapy, multidrug-resistant human immunodeficiency virus (HIV) remains a major challenge. Novel agents with unique mechanisms of action and long-acting formulations are needed to improve treatment outcomes, adherence, and patient support. Lenacapavir is the first agent in the class HIV-capsid inhibitors. It disrupts multiple stages of viral replication, including capsid disassembly, nuclear import, and virion maturation. Its administration by long-acting subcutaneous formulation enables dosing every six months, addressing non-compliance associated with daily oral therapy. Lenacapavir shows potent antiviral activity against both treatment-naïve and multidrug-resistant HIV-1 strains. Lenacapavir is a potentially transformative HIV prevention tool, indicated in pre-exposure prophylaxis. Pharmacists play a crucial role in optimising therapy by providing patient education, monitoring adherence, managing drug–drug interactions, and supporting both treatment and preventative strategies, including potential long-acting pre-exposure prophylaxis. Overall, lenacapavir provides a promising and practical alternative that could improve patient outcomes, reduce new infections through effective pre-exposure prophylaxis and strengthen ongoing efforts to control the HIV epidemic.