People with HIV participating in a recent trial of long-acting injectable cabotegravir plus Edurant (rilpivirine) were largely happy about receiving their antiretroviral (ARV) treatment only every four or eight weeks rather than taking daily pills, aidsmap reports. They found this dosing protocol more convenient and felt it allowed for greater privacy. Additionally, by not having to take pills daily they were able to avoid what they felt was a daily reminder of their HIV status .
Publishing their findings in PLOS ONE, researchers conducted a qualitative analysis of 27 participants in the LATTE-2 trial, in which HIV-positive people who were first-timers to ARV treatment were randomized to receive long-acting cabotegravir plus Edurant every four or eight weeks. The researchers also interviewed 12 health care providers for this new analysis.
By and large, the study participants were gay men in their 30s.
Most participants reported side effects; however, these symptoms were largely mild, including soreness and minor bruising at the injection site that cleared up after a day or two. A few experienced fever or impaired mobility. For the most part, the participants considered any side effects a fair trade-off given what they saw as the benefits of receiving their HIV treatment through a periodic injection rather than a daily pill.
The participants said the injections were more convenient and made for easier adherence to their HIV treatment regimen. Privacy was another important benefit of the injections, since there was no risk that others might see their daily ARVs.
A few of the study members said they were concerned about the relatively high frequency of clinic visits required to stay on a long-acting treatment regimen. They voiced concerns about privacy, speculating that others might raise questions about their need to visit the doctor so often.
Self-injection of the drugs did not seem like a feasible option to the participants; a trained medical professional, they felt, would need to administer the shot.
Most participants said they would recommend long-acting injectable treatment to others.
As for the health care providers interviewed, they were more circumspect about who would be a good candidate for long-acting injectable treatment, feeling such an assessment should be made on a case-by-case basis. They expressed concern about people with HIV needing to adhere to regular clinic visits—missing a few pills now and again might not have the greatest consequence, but missing a clinic appointment for a long-acting injection very well might.
The clinicians also pointed to the complexities of starting as well as stopping the long-acting injectable treatment, which requires a lead-in period of daily pills prior to the transition to the injections. They expressed concerns about the long “tail” of this type of treatment: The drugs can remain in the body for many months after the last injection, perhaps raising the possibility that an individual’s virus would develop resistance to certain ARVs during that time. Additionally, if an individual should develop an adverse reaction to a long-acting drug, stopping the injections would not immediately counteract that problem since the drugs would linger for so long.
To read the aidsmap article, click here.
To read the study, click here.