Department of Infection & Immunity, The Royal London Hospital, Bart Health NHS Trust.
Department of Immunobiology, The Blizard Institute, Queen Mary University of London, London, United Kingdom.
Curr Opin HIV AIDS. 2021 Mar 1;16(2):98-105. doi: 10.1097/COH.0000000000000670.
There has been significant development of long-acting injectable therapy for the management of HIV in recent years that has the potential to revolutionise HIV care as we know it. This review summarises the data and outlines the potential challenges in the field of long-acting antiretroviral therapy (ART).
In recent years, monthly and two monthly long-acting injectable ART in the form of cabotegravir and rilpivirine has shown safety and efficacy in large-scale phase 3 randomised control trials. Also, agents with novel mechanisms of action, such as Lenacapavir, have been tested in early-phase studies and are currently being tested in phase 2-3 clinical trials; if successful, this may allow six-monthly dosing schedules.
However, despite evidence that suggests that these therapies are efficacious and acceptable to patients, the challenge of integrating these agents into our current healthcare infrastructure and making these novel agents cost-effective and available to the populations most likely to benefit remains. The next frontier for long-acting therapy will be to introduce these agents in a real-world setting ensuring that the groups most in need of long-acting therapy are not left behind.
近年来长效注射抗 HIV 治疗取得了显著进展，有可能彻底改变我们所熟知的 HIV 治疗模式。本综述总结了相关数据，并概述了长效抗逆转录病毒治疗（ART）领域的潜在挑战。
近年来，卡替拉韦和利匹韦林每月和每两个月一次的长效注射 ART 在大规模 3 期随机对照试验中显示出了安全性和疗效。此外，一些具有新型作用机制的药物，如 Lenacapavir，也已在早期研究中进行了测试，目前正在进行 2-3 期临床试验；如果成功，这可能允许每 6 个月给药一次。
然而，尽管有证据表明这些疗法对患者有效且可接受，但将这些药物纳入我们当前的医疗保健基础设施，并使这些新型药物具有成本效益且可用于最有可能受益的人群，仍然是一个挑战。长效治疗的下一个前沿领域将是在真实环境中引入这些药物，以确保最需要长效治疗的人群不会被落下。
