Tony Holý Lecture – Tomáš Cihlář

Attempts to treat HIV infection and prevent almost certain death from AIDS started more than 35 years ago with the regulatory approval of the first antiretroviral drug AZT. Since then, the field has made tremendous advances and breakthroughs helping people with HIV to live normal healthy lives. Two critical landmarks on this journey included the approval of the first oral single tablet combination regimen in 2006 and the first oral antiviral pre-exposure prophylaxis in 2012. The unique partnership of IOCB, KU Leuven and Gilead was crucial for achieving both of these milestones.

Current HIV antiviral research is pushing the boundaries far beyond the standard daily oral regimens by focusing on the discovery and development of long-acting antivirals that can be administered much less frequently, offering people with HIV individualized options for tailoring the life-long treatment to their personal needs. Lenacapavir, the first-in-class long-acting HIV capsid inhibitor with a picomolar antiviral potency and unique mechanism of action represents the most recent example of this novel approach.

Existing HIV drug discovery efforts are focused on the identification of partner drugs for lenacapavir to develop both oral and injectable long-acting combinations for convenient treatment of HIV. In addition, the twice-a-year lenacapavir injection holds a potential of improving the antiviral prophylaxis for millions of people at risk of HIV acquisition. In the absence of an efficacious prophylactic HIV vaccine, success of the long-acting chemoprophylaxis would be critical for achieving the ultimate goal of ending the HIV epidemic globally.