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Long-acting antiretrovirals and HIV treatment adherence

Jean B Nachega1, Kimberly K Scarsi2, Monica Gandhi3

  • 1Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA; Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA; Center for Global Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA; Department of Epidemiology and Department International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

The Lancet. HIV
|April 16, 2023
PubMed

Insights

Long-acting injectable antiretroviral therapy (ART) offers a new option for HIV treatment, reducing injections from daily pills to monthly or bimonthly doses. Further research is needed to confirm its effectiveness and cost-efficiency across diverse patient groups and settings.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Public Health

Background:

  • Long-acting injectable antiretroviral therapy (ART) represents a significant advancement in HIV management.
  • Current daily oral ART regimens require consistent adherence, posing challenges for some individuals.
  • The development of long-acting formulations aims to improve treatment convenience and adherence.

Purpose of the Study:

  • To introduce the novel long-acting injectable combination of cabotegravir and rilpivirine for HIV treatment.
  • To highlight the potential of long-acting ART to revolutionize HIV care, prevention, and treatment.
  • To identify areas requiring further investigation for widespread adoption of long-acting ART.

Main Methods:

  • The abstract discusses the approval and use of intramuscular injections of long-acting cabotegravir and rilpivirine.
  • It reviews the reduced dosing frequency from daily oral intake to monthly or bimonthly injections.
  • The text implies a review of existing data and clinical development stages for long-acting ART.

Main Results:

  • Long-acting cabotegravir with rilpivirine is approved as a fully suppressive HIV regimen.
  • Dosing frequency is reduced to once every month or every two months.
  • This marks a new era with other long-acting antiretrovirals in development.

Conclusions:

  • Long-acting ART holds immense promise for transforming HIV treatment standards.
  • More data are essential to confirm efficacy and cost-effectiveness in specific populations (e.g., those at risk of non-adherence, different age groups, pregnant/postpartum individuals).
  • Policy changes and advocacy are crucial for equitable global access, particularly in low- and middle-income countries.

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