Long-acting injectable HIV regimens show promise

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Long-acting injectable therapy for HIV appears to maintain viral suppression as effectively as daily oral treatment, according to an international, industry-funded, phase 2b trial. The results were presented on Monday at the International AIDS Society annual meeting and published in the Lancet.

Nearly 300 previously untreated adults who achieved HIV viral suppression during 20 weeks’ treatment with oral cabotegravir plus abacavir-lamivudine were randomized to continue oral therapy or switch to intramuscular injections of long-acting cabotegravir plus rilpivirine every 4 weeks (2 injections) or 8 weeks (3 injections). Cabotegravir is an experimental integrase strand transfer inhibitor.

At 32 weeks after randomization, rates of continued viral suppression were similar in the three groups: 91% with oral treatment, 94% with 4-week injections, and 95% with 8-week injections. At week 96, viral suppression rates were 84%, 87%, and 94%, respectively. There were no serious, drug-related adverse events.

HIV expert Dr. Paul Sax commented, “The importance of this study is that many patients with HIV have expressed interest in alternatives to taking medications daily, and the results confirm that this is feasible. However, as this regimen is currently configured — with the manufacturer planning to seek FDA approval for two non-self-administered injections every 4 weeks — it is unlikely to be broadly adopted until there are less frequent or more easily given strategies.”

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