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Friday, Dec 02, 2022

Cabotegravir & rilpivirine: Injectible treatment combination for HIV patients

A treatment for HIV, a combination of infections cabotegravir and rilpivirine, has been recommended in the UK. Why is this significant?

While there is no cure for HIV, infected people can manage the virus with the help of medication.

Last week, the UK’s National Institute for Health and Care Excellence (NICE) published a draft guidance recommending the country’s first long-acting injectable treatment for HIV-1 infection in adults.

The recommended treatment is a combination of the injections cabotegravir (also called Vocabria and made by Viiv Healthcare) with rilpivirine (also called Rekambys and made by Janssen).

Oral vs injections

While there is no cure for HIV, infected people can manage the virus with the help of medication. At the moment, treatment involves lifelong antiretroviral tablets that need to be taken every day. The objective is to keep viral loads to levels at which the infection cannot be detected and transmitted between individuals.

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“Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment. However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle,” NICE quoted Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Assessment at NICE, as saying.

Clinical trials have shown that administering cabotegravir with rilpivirine is as effective as oral antiretrovirals at keeping the viral load low. NICE has recommended the combination as an option for adults with HIV-1 infection in those cases when antiretroviral medicines have kept viral loads to low levels and there is no evidence of viral resistance.

These injections are to be administered separately every two months after an initial oral tablet lead-in period.

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Who benefits

About 13,000 people in England will be eligible for injectable treatment, according to NICE. However, the London School of Hygiene & Tropical Medicine (LSHTM) quoted Professor Alison Grant, Dean of its Faculty of Infectious and Tropical Diseases, as saying that the new guidance is still only a recommendation and “there is still much to do before clinics can give these injections to patients; this will take at least several months”.

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First published on: 22-11-2021 at 10:43:46 am
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