Parikh Urvi M, Gandhi Monica, Altamirano Jessica, Safa Hussein, Hazra Aniruddha, Gomez Lisa Georgetti, Shukla Prerak, Hedberg Trevor, Heaps Amy L, Halvas Elias K, Kuncze Karen, Okochi Hideaki, Walworth Charles, Conroy Amy, Bositis Chris, Chu Carolyn, Mellors John W, Koss Catherine A
University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
University of California, San Francisco, San Francisco, California, USA.
Open Forum Infect Dis. 2025 May 12;12(6):ofaf285. doi: 10.1093/ofid/ofaf285. eCollection 2025 Jun.
HIV-1 breakthrough on long-acting cabotegravir (CAB-LA) for HIV prevention is rare but could impact viral suppression on integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART). We report the first study of ART outcomes following CAB-LA breakthrough during routine clinical care. Three individuals acquired HIV-1 on CAB-LA despite on-time injections; 2 had low-frequency major INSTI resistance mutations. All started darunavir-based ART; 1 subsequently switched to bictegravir-based ART. All maintained plasma HIV-1 RNA <50 copies/mL through ≥5 months post-ART initiation, providing early evidence of virologic success with standard ART regimens and paving the way for longer-term studies on optimal ART after CAB-LA breakthrough.
在用于预防艾滋病病毒（HIV）的长效卡博特韦（CAB-LA）上出现HIV-1突破的情况很少见，但可能会影响基于整合酶链转移抑制剂（INSTI）的抗逆转录病毒疗法（ART）对病毒的抑制作用。我们报告了在常规临床护理期间CAB-LA突破后ART疗效的首项研究。三名个体尽管按时注射CAB-LA仍感染了HIV-1；其中2人有低频主要INSTI耐药突变。所有人均开始了基于达芦那韦的ART治疗；其中1人随后改用了基于比克替拉韦的ART。所有人在ART启动后≥5个月内均维持血浆HIV-1 RNA＜50拷贝/毫升，这为标准ART方案的病毒学成功提供了早期证据，并为CAB-LA突破后最佳ART的长期研究铺平了道路。
