Long-acting ART induces viral suppression in people with HIV

People with HIV (PWH) who are treated with long-acting (LA) antiretroviral therapy (ART) achieve virologic suppression, as do those with viraemia and challenges to adherence, reports a study.

This observational cohort study was conducted in an urban academic safety-net HIV clinic and involved publicly insured adults living with HIV with and without viral suppression, high rates of unstable housing, mental illness, and substance use.

Participants received LA injectable cabotegravir and rilpivirine. The authors then used descriptive statistics to summarize cohort outcomes to date based on pharmacy team logs and electronic medical record data.

A total of 133 PWH at the HIV clinic (median age 46 years, 62 percent non-White, 88 percent cisgender men, 42 percent had unstable housing or were homeless, and 34 percent had substance use) initiated LA-ART between June 2021 and November 2022. Of these, 76 had virologic suppression while using oral ART and 57 had viraemia.

All the PWH who had virologic suppression (100 percent, 95 percent confidence interval [CI], 94‒100) maintained such suppression. Among those with viraemia, 54 achieved viral suppression, one showed the expected 2-log₁₀ reduction in HIV RNA level, and two experienced early virologic failure at a median of 33 days.

Some 97.5 percent (95 percent CI, 89.1‒99.8) of PWH were expected to achieve virologic suppression by a median of 33 weeks.

The current virologic failure rate of 1.5 percent in this cohort is comparable to that in registrational clinical trials at 48 weeks.

“Further data on the ability of LA-ART to achieve viral suppression in people with barriers to adherence are needed,” the authors said.