Hundreds of people living with drug-resistant HIV in the UK are set to receive a new treatment through the NHS, offering a potentially life-saving option to those for whom conventional medicines have stopped working. NHS England has announced that lenacapavir, described as a “trailblazing” treatment, will now be routinely available to a small group of patients.

While modern antiretroviral therapies allow the vast majority of people with HIV to live long and healthy lives, a small number develop resistance to multiple medicines. For these patients, controlling the virus can become extremely difficult and can put their health at serious risk.

Lenacapavir works differently from most existing HIV medicines. Rather than targeting enzymes used by HIV to reproduce, it targets the virus’s protective outer shell, known as the capsid, preventing the virus from making further copies of itself. The drug is a form of pre-exposure prophylaxis (PrEP)

The treatment begins with tablets taken over the first few days, followed by injections. Patients initially take tablets for two days and a further tablet on day eight. Two injections are then given on day 15, after which patients move to an injection every six months. The longer-lasting treatment could make it easier for people to maintain their medication schedule and avoid the challenges associated with taking daily tablets.

NHS England estimates that almost 300 people in England could be eligible for lenacapavir during the first three years of its availability. Patients with drug-resistant HIV who are currently eligible are expected to be contacted within weeks so they can begin treatment as soon as possible.

John Stewart, National Director for Specialised Commissioning at NHS England, said: ‘This trailblazing drug will offer a lifeline to people living with HIV for whom conventional treatments have not worked and options are currently limited, giving them the opportunity to live a normal, healthy and long life.”

Stewart added, “Alongside the NHS’s opt-out blood testing programme in A&Es, which is finding thousands of undiagnosed cases every year, and the rollout of home-testing kits and new injectable treatments, this is another step forward in care that will bring us closer to our goal of eliminating HIV in England the next decade.”

The rollout forms part of efforts to end HIV transmissions in England by 2030. Other measures include opt-out HIV testing in A&E departments, home-testing kits available through the NHS App and a national programme encouraging people who have disengaged from HIV care to return to treatment.

Daniel Fluskey, Director of Policy at the National AIDS Trust, said: “This is a huge decision for people who need life-saving treatment and takes us a step closer to ensuring that no one dies from AIDS-related illnesses here in the UK.”

Richard Angell OBE, Chief Executive of Terrence Higgins Trust, said: “For the small number of people for whom a daily pill does not work – most likely those who took earlier HIV medication or acquired HIV at birth – the option of injectable treatment presents them with hope. For them, this news is not just game-changing; it’s lifesaving. We’re grateful to everyone who has worked so hard to make this happen.”