The New Era of Long-Acting Antiretroviral Therapy: When and Why to Make the Switch.

IF 3.7 2区医学 Q2 INFECTIOUS DISEASES

Current HIV/AIDS Reports Pub Date : 2023-10-01 Epub Date: 2023-09-21 DOI:10.1007/s11904-023-00665-x

Melanie C Goebel, Emmanuel Guajardo, Thomas P Giordano, Shital M Patel

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Abstract

Purpose of review: Despite the availability of safe and effective oral combination antiretroviral therapy, barriers to maintaining viral suppression remain a challenge to ending the HIV epidemic. Long-acting injectable antiretroviral therapy was developed as an alternative to daily oral therapy. This review summarizes the current literature on the efficacy of long-acting cabotegravir plus rilpivirine for the treatment of HIV-1, reasons to switch to injectable therapy, and barriers to switching.

Recent findings: Long-acting cabotegravir plus rilpivirine is safe and effective in maintaining HIV-1 virologic suppression. Ideal candidates for switching to long-acting cabotegravir plus rilpivirine are virologically suppressed on oral regimens with good adherence and no history of virologic failure or baseline resistance. Indications to switch to injectable therapy include patient preference, the potential for improved adherence, and avoidance of adverse effects. Implementation research is needed to assess and overcome system barriers. Long-acting cabotegravir plus rilpivirine is a novel alternative to oral antiretrovirals, with the potential to improve adherence and quality of life in people with HIV.

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长效抗逆转录病毒疗法的新时代：何时以及为什么要做出改变。

审查目的：尽管有安全有效的口服联合抗逆转录病毒疗法，但维持病毒抑制的障碍仍然是结束艾滋病毒流行的挑战。开发了长效注射抗逆转录病毒疗法，作为日常口服疗法的替代方案。这篇综述总结了目前关于长效卡博替拉韦联合利匹韦林治疗HIV-1的疗效、改用注射疗法的原因以及改用的障碍的文献。最近的发现：长效卡博韦加利匹韦林在维持HIV-1病毒抑制方面是安全有效的。改用长效卡博韦加利匹韦林的理想候选者在口服方案中受到病毒学抑制，具有良好的依从性，没有病毒学失败或基线耐药性史。转向注射治疗的适应症包括患者偏好、改善依从性的潜力以及避免不良反应。需要进行实施研究，以评估和克服系统障碍。长效卡博替拉韦加利匹韦林是口服抗逆转录病毒药物的一种新替代品，有可能改善艾滋病毒感染者的依从性和生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current HIV/AIDS Reports INFECTIOUS DISEASES-

CiteScore

8.10

自引率

2.20%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.