The New Era of Long-Acting Antiretroviral Therapy: When and Why to Make the Switch

Purpose of Review Despite the availability of safe and effective oral combination antiretroviral therapy, barriers to maintaining viral suppression remain a challenge to ending the HIV epidemic. Long-acting injectable antiretroviral therapy was developed as an alternative to daily oral therapy. This review summarizes the current literature on the efficacy of long-acting cabotegravir plus rilpivirine for the treatment of HIV-1, reasons to switch to injectable therapy, and barriers to switching. Recent Findings Long-acting cabotegravir plus rilpivirine is safe and effective in maintaining HIV-1 virologic suppression. Ideal candidates for switching to long-acting cabotegravir plus rilpivirine are virologically suppressed on oral regimens with good adherence and no history of virologic failure or baseline resistance. Indications to switch to injectable therapy include patient preference, the potential for improved adherence, and avoidance of adverse effects. Implementation research is needed to assess and overcome system barriers. Summary Long-acting cabotegravir plus rilpivirine is a novel alternative to oral antiretrovirals, with the potential to improve adherence and quality of life in people with HIV.

综述目的 尽管存在安全有效的口服抗逆转录病毒联合疗法，但维持病毒抑制的障碍仍然是终结艾滋病流行的一项挑战。长效注射用抗逆转录病毒疗法是作为每日口服疗法的一种替代方案而研发的。本综述总结了当前有关长效卡博特韦加利匹韦林治疗HIV - 1的疗效、转换为注射疗法的原因以及转换障碍的文献。 近期研究结果 长效卡博特韦加利匹韦林在维持HIV - 1病毒学抑制方面是安全有效的。转换为长效卡博特韦加利匹韦林的理想候选者是那些采用口服方案且病毒学得到抑制、依从性良好、无病毒学失败史或基线耐药情况的患者。转换为注射疗法的指征包括患者偏好、提高依从性的可能性以及避免不良反应。需要开展实施性研究来评估和克服系统性障碍。 总结 长效卡博特韦加利匹韦林是口服抗逆转录病毒药物的一种新型替代方案，有可能改善艾滋病患者的依从性和生活质量。