Long-acting antiretrovirals and HIV treatment adherence

Summary

Intramuscular injection of long-acting cabotegravir and rilpivirine is a novel, long-acting antiretroviral therapy (ART) combination approved for use as a fully suppressive regimen for people living with HIV. Long-acting cabotegravir with rilpivirine ART has reduced required dosing frequency from once daily to once every month or every 2 months injections. This new era of long-acting ART, which includes other antiretrovirals and formulations in various stages of clinical development, holds tremendous promise to change the standard of HIV treatment. Although long-acting ART has high potential to be revolutionary in the landscape of HIV care, prevention, and treatment cascade, more data are needed to substantiate its efficacy and cost-effectiveness among patients at risk of non-adherence and across age groups, pregnancy, and post partum. Advocacy efforts and policy changes to optimise a sustained, high-quality, equitable reach of long-acting ART, especially in low-income and middle-income countries where most people living with HIV reside, are needed to realise the full benefits of long-acting ART.

Authors:

• Prof Jean B Nachega, PhD  ^†
• Prof Kimberly K Scarsi, PharmD ^†
• Prof Monica Gandhi, MD
• Rachel K Scott, MD
• Lynne M Mofenson, MD
• Prof Moherndran Archary, PhD
• Prof Sharon Nachman, MD
• Prof Eric Decloedt, PhD
• Prof Elvin H Geng, MD
• Lindsay Wilson, MSc
• Angeli Rawat, PhD
• Prof John W Mellors, MD