Long-Acting HIV Therapies: Real-World Data and Clinical Application

Long-Acting Injectable Therapy – Real-World Evidence

Key Themes:

• Injectable Option: Cabotegravir (integrase inhibitor) plus rilpivirine as an intramuscular injection given every other month
• Real-World Performance: The OPERA cohort followed nearly 3000 US patients receiving this combination outside clinical trials.
• Adherence Challenges: Importance of timely injections, with 62% of patients receiving injections on schedule and 12% missing injections
• Clinical Implications: Risk of resistance development if injections are delayed or missed

Notable Insights from Dr Sharon Walmsley:

• Real-world virologic suppression rates exceeded 95%, with less than 1% experiencing virologic failure, mirroring clinical trial results.
• High body mass index was not associated with treatment failure in this cohort, contrasting with some earlier studies, likely due to improved administration techniques (longer needles).
• Injectable therapy offers psychological benefits to patients who are “tired of swallowing pills” or find daily oral medication a constant reminder of HIV status.
• Clinics need systematic approaches to track and ensure timely administration of injections to prevent resistance development.