Evidence map›Paper›PMID 40543515›Full record

ReviewThe lancet. HIV2025

Lenacapavir-associated drug resistance: implications for scaling up long-acting HIV pre-exposure prophylaxis.

Gert van Zyl, Mateo Prochazka, Heather-Marie Ann Schmidt, Catherine Orrell, Jonathan M Schapiro, Suzanne M McCluskey, Marco Vitoria, Rami Kantor, Urvi M Parikh, Michelle Rodolph and 2 more

Abstract readReview
In one paragraph

Review in The lancet. HIV, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Review
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  8. Highly efficient production of HIV-1Journal of virology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Gert van ZylDivision of Medical Virology, Stellenbosch University, Cape Town, South Africa; National Health Laboratory Service, Cape Town, South Africa.
Mateo ProchazkaGlobal HIV, Hepatitis and STIs Programme, WHO, Geneva, Switzerland.
Heather-Marie Ann SchmidtGlobal HIV, Hepatitis and STIs Programme, WHO, Geneva, Switzerland.
Catherine OrrellDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Jonathan M SchapiroNational Hemophilia Center, Sheba Medical Center, Ramat Gan, Israel.
Suzanne M McCluskeyDivision of Infectious Diseases, Harvard Medical School, Boston, MA, USA.
Marco VitoriaGlobal HIV, Hepatitis and STIs Programme, WHO, Geneva, Switzerland.
Rami KantorDivision of Infectious Diseases, Department of Medicine, Brown University, Providence, RI, USA.
Urvi M ParikhDivision of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Michelle RodolphGlobal HIV, Hepatitis and STIs Programme, WHO, Geneva, Switzerland.
Michael R JordanDivision of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA; Global Health and Tropical Medicine, LA-REAL, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal.
Robert W ShaferDivision of Infectious Diseases, Department of Medicine, Stanford University, Stanford, CA, USA. Electronic address: rshafer@stanford.edu.

Funding

HIV Drug Resistance DatabaseR24AI136618 · NIAID · STANFORD UNIVERSITY · PI ROBERT William SHAFER · 2018 to 2026
$7.3M
NIAID NIH HHS R24 AI136618World Health Organization 001
6 · The paper itself

Abstract

Although drug resistance could emerge if lenacapavir is initiated during undiagnosed acute infection or if infection occurs during the drug's pharmacokinetic tail, these cases will not compromise the effectiveness of WHO-recommended therapies, as there is no cross-resistance between lenacapavir and other licensed antiretroviral drugs. Lenacapavir pre-exposure prophylaxis (PrEP) is also unlikely to drive population-level lenacapavir resistance given the rarity of breakthrough infections and the reduced replication capacity of most lenacapavir-resistant variants, which most likely reduces their transmission potential. Conversely, the risk of acquiring lenacapavir-resistant HIV-1 while receiving lenacapavir PrEP is likely to remain extremely low, as lenacapavir-associated drug-resistance mutations are rare among individuals without previous lenacapavir exposure, and widespread use of lenacapavir-based regimens remains years away. Nonetheless, as the number of lenacapavir PrEP programmes increase, surveillance for emerging lenacapavir resistance should also be implemented.

Indexed as

Anti-HIV AgentsDrug Resistance, ViralHIV-1HIV InfectionsPre-Exposure ProphylaxisAcetamidesHumansIndazolesAcetamidesAnti-HIV AgentsIndazoleslenacapavir

Identifiers

PMID40543515
PMCPMC12435527

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.