An international clinical trial led by researchers including Professor Chloe Orkin of Queen Mary University of London has shown that a once-weekly oral treatment for HIV is as effective as one of today's leading daily therapies, offering the potential for a new treatment option that could reduce the burden of lifelong daily pill-taking.
The findings, published today in the New England Journal of Medicine and presented at the International AIDS Conference in Rio de Janeiro, come from the Phase 3 ISLEND-1 trial, which evaluated a once-weekly tablet combining islatravir and lenacapavir in adults whose HIV was already well controlled.
The international study involved 607 adults across 106 clinical sites in 12 countries. Participants who had maintained viral suppression on standard daily treatment were randomly assigned either to switch to the once-weekly tablet or remain on their existing daily medication.
After 48 weeks, the once-weekly regimen proved non-inferior to the standard once-daily treatment. More than 93% of participants in both groups maintained viral suppression, while no participants receiving the weekly treatment experienced virological failure during the study.
The study addresses one of the continuing challenges in HIV care. Although modern medicines have transformed HIV into a manageable long-term condition, taking medication every day can still contribute to stigma and treatment fatigue for some people. A once-weekly oral treatment could provide greater flexibility while avoiding the need for injectable therapies.
Professor Chloe Orkin MBE, Professor of Infection and Inequities and Dean for Healthcare Transformation at Queen Mary University of London, and senior author of the study, said:
"The first ever weekly oral therapy for the treatment of HIV could offer welcome relief from the burden of life-long daily pill-taking for people living with HIV. This is especially important for people that are experiencing stigma and people with other HIV-associated health conditions who are taking multiple other tablets."
The weekly tablet combines two long-acting antiretroviral medicines — islatravir and lenacapavir — with complementary mechanisms of action that enable effective once-weekly dosing. Researchers believe the once weekly tablet could offer an important additional treatment choice for people living with HIV.
The study remains ongoing and participants will continue to be followed for a total of 96 weeks to assess longer-term safety and effectiveness.
