Long-Acting HIV Injectable Effective Regardless of Viremia

TOPLINE:

Long-acting antiretroviral therapy (LA-ART) maintained high viral suppression for 48 weeks in patients with HIV regardless of initial viremia.

METHODOLOGY:

• Researchers examined viral suppression for 48 weeks following the initiation of LA-ART — a cabotegravir plus rilpivirine regimen — in patients with HIV comparing those with viremia (≥ 30 copies/mL of HIV RNA) with those without it.
• They included a total of 370 patients (median age, 44 years; 80% cisgender men), including 129 with viremia and 241 without it, by using data from electronic medical records between January 2021 and September 2024.
• Patients with viremia were required to attend monthly in-person visits, and injections were given bimonthly after 3 months if an undetectable viral load (< 30 copies/mL of HIV RNA) was achieved.

TAKEAWAY:

• Patients with initial viremia had higher rates of substance use (60% vs 39%; P < .001), housing instability (51% vs 37%; P = .007), and low CD4+ counts of < 200 cells/mm³ (77% vs 59%; P < .001) than those without it.
• The median time to achieve an undetectable viral load in patients with viremia was 32 days (95% CI, 30-45).
• At 48 weeks, 98% of patients with initial viremia and 99% of those without it achieved undetectable viral loads, with no significant difference noted between both groups (P = .61).

IN PRACTICE:

“In 2024, data from the program were cited in modifications to the US Department of Health and Human Services and International Antiviral Society-USA HIV treatment guidelines to recommend LA-ART among people with HIV with viremia and adherence challenges. These comparison data further bolster changes to HIV treatment guidelines,” the study authors wrote.

SOURCE:

The study was led by Matthew A. Spinelli, MD, MAS, University of California, San Francisco. It was published online on March 6, 2025, in JAMA.

LIMITATIONS:

The study had a cross-sectional design. Some participants had limited follow-up. Finally, it was conducted at a single center.

DISCLOSURES:

This study was supported by the National Institutes of Health/National Institute of Allergy and Infectious Diseases. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.