Long-acting antiretrovirals and HIV treatment adherence

Affiliations

¹ Department 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. Electronic address: jbn16@pitt.edu.
² Antiviral Pharmacology Laboratory, College of Pharmacy, and Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
³ Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
⁴ MedStar Health Research Institute and MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC, USA.
⁵ Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.
⁶ Department of Pediatrics, King Edward VIII Hospital, University of Kwa Zulu Natal, Durban, South Africa.
⁷ Department of Pediatrics, Stony Brook Children's, SUNY Stony Brook University, Stony Brook, NY, USA.
⁸ Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁹ Division of Infectious Diseases, Department of Medicine, and Institute for Public Health, Washington University, St Louis, MO, USA.
¹⁰ Platform Life Sciences, Vancouver, BC, Canada.
¹¹ Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; School of Population and Public Heath, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹² Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.

PMID: 37062293
PMCID: PMC10734401
DOI: 10.1016/S2352-3018(23)00051-6

Review

Long-acting antiretrovirals and HIV treatment adherence

Jean B Nachega et al. Lancet HIV. 2023 May.

. 2023 May;10(5):e332-e342.

doi: 10.1016/S2352-3018(23)00051-6. Epub 2023 Apr 14.

Authors

Affiliations

¹ Department 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. Electronic address: jbn16@pitt.edu.
² Antiviral Pharmacology Laboratory, College of Pharmacy, and Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
³ Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
⁴ MedStar Health Research Institute and MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC, USA.
⁵ Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.
⁶ Department of Pediatrics, King Edward VIII Hospital, University of Kwa Zulu Natal, Durban, South Africa.
⁷ Department of Pediatrics, Stony Brook Children's, SUNY Stony Brook University, Stony Brook, NY, USA.
⁸ Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
⁹ Division of Infectious Diseases, Department of Medicine, and Institute for Public Health, Washington University, St Louis, MO, USA.
¹⁰ Platform Life Sciences, Vancouver, BC, Canada.
¹¹ Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; School of Population and Public Heath, University of British Columbia, Vancouver, BC, Canada; Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹² Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.

PMID: 37062293
PMCID: PMC10734401
DOI: 10.1016/S2352-3018(23)00051-6

Abstract

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.

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Conflict of interest statement

Declaration of interests RKS reports investigator-sponsored research awards from Gilead Science and ViiV Healthcare; and awards managed by MedStar Health Research Institute. KKS reports investigator-initiated research funding paid to her institution from Organon. LMM reports funding from ViiV Healthcare provided to the Elizabeth Glaser Pediatric AIDS Foundation for a birth outcomes surveillance project in Eswatini; and serving as a paid consultant to WHO on the safety of antiretroviral drugs in pregnancy. JWM is a consultant to Gilead Sciences and a grant recipient from Gilead Sciences to the University of Pittsburgh. All other authors declare no competing interests.

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Comment in

Long-acting antiretrovirals: research and implementation considerations in Africa.
Norcross C, Ombajo LA, Kassim S, Garrett N, Cresswell FV, Ruzagira E. Norcross C, et al. Lancet HIV. 2023 Jul;10(7):e428-e429. doi: 10.1016/S2352-3018(23)00134-0. Lancet HIV. 2023. PMID: 37419566 No abstract available.

References

1. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/archive/Adul... (accessed Oct 31, 2022).
1. Altice F, Evuarherhe O, Shina S, Carter G, Beaubrun AC. Adherence to HIV treatment regimens: systematic literature review and meta-analysis. Patient Prefer Adherence 2019; 13: 475–90. - PMC - PubMed
1. Kerrigan D, Mantsios A, Gorgolas M, et al. Experiences with long acting injectable ART: a qualitative study among PLHIV participating in a Phase II study of cabotegravir + rilpivirine (LATTE-2) in the United States and Spain. PLoS One 2018; 13: e0190487. - PMC - PubMed
1. US Food and Drug Administration. CABENUVA (cabotegravir extended-release injectable suspension; rilpivirine extended-release injectable suspension), co-packaged for intramuscular use. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/212888s005s006... (accessed Oct 18, 2022).
1. Scarsi KK, Swindells S. The promise of improved adherence with long-acting antiretroviral therapy: what are the data? J Int Assoc Provid AIDS Care 2021; 20: 23259582211009011. - PMC - PubMed

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Long-acting antiretrovirals and HIV treatment adherence

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Long-acting antiretrovirals and HIV treatment adherence

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Conflict of interest statement

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