Weekly HIV Pill Could Replace Daily Tablet, Trial Finds

The results come from the ISLEND-1 trial, published by the New England Journal of Medicine. The study looked at patients whose HIV-1 (the most common type of the virus) was already suppressed — meaning the virus was undetectable in their blood — while taking a daily combination tablet called bictegravir–emtricitabine–tenofovir alafenamide, known as B/F/TAF.

Those patients were then switched to a once-weekly oral combination of two newer drugs: islatravir and lenacapavir. The trial found the weekly regimen was non-inferior — meaning it performed no worse — than staying on the daily tablet for maintaining viral suppression.

That’s a meaningful finding.

For people living with HIV, daily medication is the current standard. Missing doses can allow the virus to replicate and, over time, may lead to drug resistance. A once-weekly option — if it clears regulatory approval — could make it easier for some patients to stick to their treatment.

The New England Journal of Medicine posted the full phase 3 results, describing the outcome as non-inferiority in maintaining suppression among participants who switched regimens. Non-inferiority trials are designed to show that a new treatment is not meaningfully worse than an existing one, rather than proving it is better.

Islatravir and lenacapavir are both antiretroviral (anti-HIV) drugs, though they work through different mechanisms to block the virus from reproducing. Lenacapavir is already available in injectable form for some patients in the UK; the oral weekly combination tested here is a separate development.

The trial results do not mean the weekly combination is available yet. Regulatory review by bodies such as the Medicines and Healthcare products Regulatory Agency (MHRA) would be required before any new treatment reaches NHS prescribing.

Anyone with questions about HIV treatment should speak to their GP or HIV specialist clinic. General health advice is available through NHS 111.