Lenacapavir-Based Salvage Therapy in Heavily Treatment-Experienced Multidrug-Resistant HIV-1: A Case Report From the United Arab Emirates.

Management of heavily treatment‑experienced people with HIV remains challenging due to cumulative drug resistance and limited therapeutic options. We report the case of a cisgender female with HIV‑1 subtype A1 and extensive antiretroviral therapy (ART) resistance who experienced more than a decade of suboptimal viral suppression despite multiple ART regimens. The patient accumulated resistance to all nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), all non‑nucleoside reverse transcriptase inhibitors (NNRTIs), and nearly all protease inhibitors (PIs), with limited remaining treatment options. Following virologic rebound in 2023 and failure of subsequent salvage regimens, lenacapavir was initiated in 2024 in combination with an optimized background regimen of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF). The patient rapidly achieved an undetectable viral load and remains virologically suppressed to date.