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.
PURPOSE OF REVIEW: 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. RECENT FINDINGS: 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.
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