Researchers are continuously looking for new ways to treat HIV. One of the biggest problems with HIV treatment is adherence to medication. Patients who start treatment need to take their medication daily and missing only a few doses could potentially lead to resistance to that particular combination of medication. A new form of treatment is currently progressing through clinical trials in the form of long acting injectable HIV medication and results so far are promising.
Currently two drugs are being investigated for this purpose. An experimental integrase inhibitor, Cabotegravir and an NNRTI rilpivirine are being tested as a combination for people who have already been virally suppressed on a regular 3 drug combination. The injection being tested in the phase 2b LATTE 2 trial is being given either every 4 or 8 weeks and the combination has so far maintained viral suppression for at least 32 weeks and seems safe and well tolerated. The results showed that it works as well as the standard oral medications in maintaining viral suppression.
The injectable was tested following previous studies that showed that a 2 drug oral maintenance therapy was as effective in suppressing viral load in people who have already achieved undetectable status. The injectable are being studied now as a way to potentially make life easier for those who have to take long term HIV therapy and to simplify treatment with the hope that we can reduce side effects and eliminate adherence issues.
Once the safety of oral cabotegravir and rilpvirine had been established the researchers moved on to injectables. At the end of the 32 week traeement period 95% of patients who received the injection every 8 weeks remained virally suppressed. The most common side effect was injection site pain. Follow up will continue up to 96 weeks and the co-formulation will also move into phase 3 trials. If these are successful we could someday soon see a completely different and hopefull easier treatment regime for HIV postive individuals. The drugs are also being tested to see how effective they would be for pre exposure prophylaxis.