CIDRAP-Long-acting injected combo drug keeps HIV in check, real-world study finds

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Long-acting injected combo drug keeps HIV in check, real-world study finds

www.cidrap.umn.edu

Long-acting injected combo drug keeps HIV in check, real-world study finds​

Liz Szabo, MA

Today at 10:37 a.m.
HIV/AIDS


A new study finds that a long-acting, injectable treatment for HIV works as well in the real world as in controlled clinical trials.

Researchers found that Cabenuva, an injection of the drugs cabotegravir and rilpivirine, suppressed HIV to undetectable levels in 94% of people in the study, presented today at ID Week, a medical conference about infectious diseases in Washington, DC.

Reducing the amount of HIV in the blood to levels too small to be detected by standard tests is a key goal of treatment, because it helps keep people healthy and prevents them from transmitting the virus.

Leaders of the study were surprised that the injections were so popular, said Ricky Hsu, MD, first author of the study and associate clinical professor at NYU Medical Center in New York City.

About 85% of the nearly 7,000 US patients in the study, all of whom were doing well on daily pills, opted to try the long-acting injectable medication, said Hsu, who spoke at a press conference last week. Injections must be administered by a health professional.

People who opted to try injectable medications made the switch from 2021 to 2025, and doctors followed their progress through February 2026.

By the end of the study, 77% of participants who opted for the long-acting injections were still taking them, Hsu said. The researchers found that 95% of patients on injectable medication got their shots on time or received only one injection later than recommended.

Psychological benefits​

Some people with HIV find that injectable medications are better for their mental health.

Taking a pill every day is an unwelcome reminder for some with HIV that they are living with a chronic illness, said George Froehle, a physician assistant and HIV specialist at the Aliveness Project, an HIV clinic in Minneapolis, Minnesota.

“We didn't realize the psychological toll of taking an HIV pill every day for some patients,” said Froehle, who wasn’t involved in the new study. Switching to a monthly or bimonthly injection allows people to “think less about their HIV infection, and they still remain undetectable. It's been a big benefit for some of our folks.”

Hsu, who has taken care of people with HIV for 30 years, said it’s good for people to have choices about their treatment regimen.

“Having seen the HIV treatment landscape evolve over the last few decades, I really do think that we're sort of in a new era of patient treatment,” Hsu said. “We’re focusing on patient-centered therapy and focusing on patient’s individual needs.”

Uptake remains low​

Although Cabenuva has been on the market for five years, it’s taken by only about 5% of people with HIV, Hsu said.

There are a number of barriers that prevent people from taking the medication, Froehle said.

In about 10% of people with HIV, the virus is resistant to one of the drugs in Cabenuva, rilpivirine.

Having seen the HIV treatment landscape evolve over the last few decades, I really do think that we're sort of in a new era of patient treatment.

Cabenuva also isn’t appropriate for people with both HIV and hepatitis B. For these patients, clinicians usually prescribe a drug combination that treats both infections, Froehle said.

And although the injections can cause muscle soreness for a couple days, “most people tolerate it well,” Froehle said.