New Single Pill Simplifies HIV Treatment for Older Patients

For people who have lived with HIV for decades, taking a dozen pills every day has been the price of survival. Now a single pill could transform their daily routine and quality of life.

A new clinical trial tested a combination pill called BIC/LEN on the oldest group ever assembled for HIV research. With an average age of 60 and some participants in their eighties, these patients have been unable to benefit from the simpler treatments available to younger people with HIV.

The reason comes down to timing. Early HIV treatments sometimes caused drug resistance in people who contracted the virus decades ago. While newer patients can take convenient once-daily pills, older patients have needed highly specialized, complex regimens to keep the virus under control.

Professor Chloe Orkin from Queen Mary University of London led the research team. "This is a drug for people who have viral resistance, who haven't been able to benefit from advances in HIV therapy," she explained.

Over nine months, the trial compared the new single pill against traditional multi-pill regimens. Both approaches suppressed the virus in around 96% of participants. But the BIC/LEN pill delivered an unexpected bonus: it improved cholesterol levels, offering extra protection against cardiovascular disease as patients age.

The Ripple Effect

The impact reaches beyond convenience. Complex medical regimens carry real risks because a single missed pill can undo vital treatment gains. Patients taking BIC/LEN reported higher satisfaction than those managing multiple medications each day.

"From the individual's perspective, this simplifies drug taking," said Mitchell Warren, executive director of HIV prevention advocacy group AVAC. "That is an incredible opportunity to make it simple for people to adhere to their drugs, to stay virologically suppressed."

The benefits extend to public health too. People on effective HIV treatment who maintain viral suppression cannot transmit the virus to others. Simpler medication routines mean better adherence, which means more people staying healthy and protecting their partners.

The pill combines two antiviral drugs: bictegravir and lenacapavir. While lenacapavir recently received approval as an injected medication, this oral combination represents something new. Testing showed it works well not just for people with complex needs, but also for those on standard therapy.

The BIC/LEN pill still needs approval from regulators including the US Food and Drug Administration and European Medicines Agency. Two follow-up assessments are underway, and the trial data was published in The Lancet medical journal in February 2025.

For a generation that has watched HIV transform from a death sentence to a manageable condition, this advance offers something they've waited years to see: the same simple treatment options everyone else gets.