Johnson Jennie E, Brotherton Amy L, Rossi Michael R, Sanchez Martha C, Beckwith Curt G
Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
Division of Infectious Diseases, Department of Medicine, The Miriam Hospital Infectious Diseases and Immunology Center, 180 Corliss Street, Suite E, Providence, RI, 02904, USA.
Curr HIV/AIDS Rep. 2025 Apr 23;22(1):31. doi: 10.1007/s11904-025-00741-4.
Long-acting injectable (LAI) antiretroviral therapy (ART) for treatment of HIV-1 are approved both as a complete treatment regimen (cabotegravir/rilpivirine) and as an additional treatment option (lenacapavir) for those with multidrug resistant HIV-1. Here, we review the data supporting these approvals, pharmacokinetics, and additional patient populations that many benefit from LAI ART.
Persons with HIV and adherence challenges as well as those in low-and-middle income countries have high rates of adherence and viral suppression with LAI ART. LAI cabotegravir/rilpivirine (CAB/RPV) offers an alternative treatment approach to daily oral ART for people with HIV-1 infection that is associated with high rates of patient satisfaction when compared to daily oral ART. LAI CAB/RPV is currently only approved in those with HIV-1 viral suppression, however recent data support the use of LAI ART in populations with adherence challenges. Furthermore, given high rates of NNRTI resistance globally, CAB/RPV is not recommended in low-and-middle income countries presently, although this recommendation is likely to change based on recently published data. More research is needed among groups that may benefit from long-acting treatments for HIV-1.
长效注射用抗逆转录病毒疗法（ART）用于治疗HIV-1，已被批准作为完整的治疗方案（卡博特韦/利匹韦林）以及用于治疗多重耐药HIV-1患者的额外治疗选择（来那卡韦）。在此，我们回顾支持这些批准的相关数据、药代动力学以及其他可能从长效注射用ART中获益的患者群体。
HIV患者中存在依从性挑战的人群以及低收入和中等收入国家的患者在接受长效注射用ART时具有较高的依从率和病毒抑制率。与每日口服ART相比，长效注射用卡博特韦/利匹韦林（CAB/RPV）为HIV-1感染者提供了一种替代每日口服ART的治疗方法，患者满意度较高。长效注射用CAB/RPV目前仅被批准用于HIV-1病毒得到抑制的患者，然而最近的数据支持在存在依从性挑战的人群中使用长效注射用ART。此外，鉴于全球非核苷类逆转录酶抑制剂（NNRTI）耐药率较高，目前在低收入和中等收入国家不推荐使用CAB/RPV，不过基于最近发表的数据，这一推荐可能会改变。对于可能从HIV-1长效治疗中获益的群体，还需要更多研究。
