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...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-07-01
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| Series: | Nature Communications |
| Online Access: | https://doi.org/10.1038/s41467-025-60752-y |
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| author | 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 |
| author_facet | 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 |
| author_sort | Andrew Phillips |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-117a2b207b7b4ae295cedc46d7df1cd4 |
| institution | Kabale University |
| issn | 2041-1723 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Nature Communications |
| spelling | doaj-art-117a2b207b7b4ae295cedc46d7df1cd42025-08-20T03:45:35ZengNature PortfolioNature Communications2041-17232025-07-0116111310.1038/s41467-025-60752-yPotential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in AfricaAndrew Phillips0Jennifer Smith1Loveleen Bansi-Matharu2Kenly Sikwese3Cissy Kityo4Charles Flexner5Marco Vitoria6Nathan Ford7Meg Doherty8Zack Panos9David Ripin10Matthew Hickey11Diane Havlir12Monica Gandhi13Michael Reid14Paul Revill15Institute for Global Health, University College LondonInstitute for Global Health, University College LondonInstitute for Global Health, University College LondonAfroCABJoint Clinical Research CentreJohns Hopkins University School of MedicineDepartment of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, WHODepartment of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, WHODepartment of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, WHOChildren’s Investment Fund FoundationClinton Health Access InitiativeUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoUniversity of California San FranciscoUniversity of YorkAbstract 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.https://doi.org/10.1038/s41467-025-60752-y |
| spellingShingle | 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 Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa Nature Communications |
| title | Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa |
| title_full | Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa |
| title_fullStr | Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa |
| title_full_unstemmed | Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa |
| title_short | Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa |
| title_sort | potential impact and cost effectiveness of long acting injectable lenacapavir plus cabotegravir as hiv treatment in africa |
| url | https://doi.org/10.1038/s41467-025-60752-y |
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