An evaluation of cabotegravir for HIV treatment and prevention

ABSTRACT

Introduction: Oral pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) represent the cornerstones of HIV infection prevention and treatment. However, despite their high efficacy, the need to take daily oral pill(s) negatively impacts long-term patient adherence. In some cases, it can also be associated with drug–drug interactions and adverse gastrointestinal effects, as well as being a constant reminder to individuals of their HIV status. The availability of long-acting non-orally administered antiretroviral drugs could, therefore, be extremely useful. Cabotegravir (CAB) is a second-generation integrase strand transfer inhibitor, characterized by a relatively high genetic barrier and good antiretroviral potency, which is administrable as a long-acting injectable suspension (LAI CAB).

Areas covered: The authors present and discuss the efficacy and available safety data of LAI CAB, either when co-administered with rilpivirine (RPV; LAI CAB + RPV) for the treatment of HIV infection, or when used as single agent for PrEP.

Expert opinion: Cabotegravir has the potential to play a primary role in the treatment and prevention of HIV infection. The future availability of LAI CAB + RPV and LAI CAB may mark the beginning of an era of LAI ART and PrEP, respectively.

KEYWORDS:

• HIV
• integrase strand transfer inhibitors
• long-acting injectable drugs
• antiretroviral treatment
• pre-exposure prophylaxis
• people living with HIV

Acknowledgments

The authors would like to thank JournalEdit for editing and reviewing this manuscript for English language.

Box 1. Drug summary box

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Article Highlights

• Abotegravir (CAB), when co-administered with rilpivirine (RPV) as a long-acting injectable (LAI) regimen for HIV treatment, has shown an overall high efficacy and good tolerability, compared to classic oral regimens.

• Data on LAI CAB as a PrEP single agent are encouraging.

• The future availability of LAI CAB + RPV and LAI CAB may mark the beginning of an era of LAI antiretroviral therapy and PrEP, respectively.

Declaration of interest

V Spagnuolo has received speaker fees from Merck Sharp and Dohme and Gilead Sciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.