March 06, 2024
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DENVER — The International Antiviral Society-USA (IAS-USA) has updated its HIV treatment guidelines to endorse the off-label use of long-acting injectable ART in patients with HIV viremia.
Long-acting cabotegravir and rilpivirine has been approved by the FDA since 2021 for people with HIV who are virologically suppressed on oral ART, have no known or suspected resistance to either drug and do not have chronic hepatitis.
The original IAS-USA guidelines published in 2022 did not recommend the long-acting regimen for patients with HIV viremia.
In this video from the Conference on Retroviruses and Opportunistic Infections, Paul E. Sax, MD, clinical director of the division of infectious diseases at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard Medical School, summarizes the updated guidance and describes the optimal criteria for the use of long-acting cabotegravir and rilpivirine by patients who otherwise cannot take oral ART.
“We’ve been aware now for several years that there are some people with HIV who are being treated with cabotegravir/rilpivirine who are viremic at baseline. Why are they viremic? Because for whatever reason, they cannot take oral antiretroviral therapy,” said Sax, who spoke on behalf of the IAS-USA Treatment Guidelines Panel.
“These reports have increased over time,” he said. “In addition, there is accumulating evidence … that this treatment can be particularly useful for people who struggle with medication adherence.”
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Sources/Disclosures
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Disclosures:
Sax reports receiving grants from Gilead Sciences and ViiV Healthcare and personal fees from Gilead, Janssen, Merck and ViiV outside the submitted work.
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