Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa

Abstract Although viral suppression is attained for most adults living with diagnosed HIV in East, Central, Southern and West Africa (ECSWA), challenges remain with sustained adherence to daily oral pill taking for some in the population. Here, we evaluate the potential effectiveness and cost-effect...

Full description

Saved in:
Bibliographic Details
Main Authors: Andrew Phillips, Jennifer Smith, Loveleen Bansi-Matharu, Kenly Sikwese, Cissy Kityo, Charles Flexner, Marco Vitoria, Nathan Ford, Meg Doherty, Zack Panos, David Ripin, Matthew Hickey, Diane Havlir, Monica Gandhi, Michael Reid, Paul Revill
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-60752-y
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Although viral suppression is attained for most adults living with diagnosed HIV in East, Central, Southern and West Africa (ECSWA), challenges remain with sustained adherence to daily oral pill taking for some in the population. Here, we evaluate the potential effectiveness and cost-effectiveness of introduction of a new combination of long-acting injectable drugs of lenacapavir + cabotegravir to increase levels of sustained viral suppression. We find there is potential for a significant impact on HIV deaths and disability adjusted life years, including due to a decrease in mother to child transmission. If lenacapavir + cabotegravir can be sourced at a cost of around $ 80 per year or less, our analysis suggests there is potential for a policy to introduce it to be cost-effective in settings in ECSWA. Recognising the limitations of a modelling study, we suggest that implementation studies be conducted to confirm the viability of these approaches.
ISSN:2041-1723