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Lenacapavir pacfosacil (GS-4182) is an investigational, long-acting oral prodrug of lenacapavir, a first-in-class HIV-1 capsid inhibitor developed by Gilead Sciences. It is designed for once-weekly oral administration as part of a simplified treatment regimen for HIV-1 infection. As a prodrug, it is metabolized in the body to release lenacapavir, which binds directly to the HIV-1 capsid protein (p24) hexamers. This binding disrupts multiple essential stages of the viral life cycle, including capsid-mediated nuclear import of viral DNA, virion assembly and release, and proper capsid core formation. Lenacapavir pacfosacil is currently being evaluated in Phase 2 and Phase 3 clinical trials, often in combination with other long-acting antiretrovirals such as the integrase strand transfer inhibitor lepetegravir (GS-1720), to provide a potent and convenient weekly oral option for people living with HIV.
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