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by JumpCrisscross 606 days ago
> This treatment does not in fact prevent HIV infection. It prevents infected cells from producing viable virus particles

Lenacapavir interferes "with multiple essential steps of the viral lifecycle, including capsid-mediated nuclear uptake of HIV-1 proviral DNA (by blocking nuclear import proteins binding to capsid), virus assembly and release (by interfering with Gag/Gag-Pol functioning, reducing production of capsid protein subunits), and capsid core formation (by disrupting the rate of capsid subunit association, leading to malformed capsids)" [1].

For comparison, tenofovir diphosphate (from Descovy) "inhibits the activity of HIV reverse transcriptase and causes DNA chain termination after getting incorporated into the viral DNA" [2].

Descovy thus works at stage 3 (reverse transcription); Lenacapavir works at stages 3 (integration), 6 (assembly) and 7 (budding) [3].

> it seems very likely that if any patient being treated with this drug ever discontinued it, they could develop HIV quickly from cells that were already infected in their body

HIV-uninhibted T cells should be fine clearing these out. IT would be more surprising to see the cells stick around after having been infected.

[1] https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e56...

[2] https://www.clinicaltrialsarena.com/projects/descovy-emtrici...

[3] https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-li...

1 comments

The references you provided are prescribing information and to other drugs which actually are anti-retroviral.

You did not provide any reference showing that cells that are actually infected but inhibited from producing virus through late stage assembly inhibitors are effectively eliminated by the immune system.

> references you provided are prescribing information and to other drugs which actually are anti-retroviral

The first reference is for literally this drug.

> did not provide any reference showing that cells that are actually infected but inhibited from producing virus through late stage assembly inhibitors are effectively eliminated by the immune system

I did not because this is the normal function of the immune system. The extraordinary claim, yours, is that these cells will somehow get missed by the immune system.

Right. It’s prescribing information.

As per whether infected cells that don’t display any evidence of virus on their surfaces would somehow be detected and killed or would undergo apoptosis, that might happen but I don’t find any evidence that it does.