Research has found that a new injectable form of PrEP is better than daily oral pills at preventing contraction of HIV. Sarah Jurado/Getty Images
- New research sheds light on the efficacy of long-acting (LA) cabotegravir in HIV pre-exposure prophylaxis (PrEP).
- It is the first and currently only long-acting injectable form of PrEP, a drug that can effectively prevent HIV infection if followed.
- This form of injectable PrEP resulted in an 89% lower rate of HIV acquisition compared to treatment with oral tablets.
Recently, at the 2022 International AIDS Conference, VIV Healthcare presented research highlighting the efficacy of long-acting cabotegravir (LA) for HIV pre-exposure prophylaxis (PrEP).
It is the first and currently only long-acting injectable form of PrEP, a drug that can effectively prevent HIV infection if followed.
This injectable form of PrEP complements other recent efforts to focus HIV prevention efforts. Experts say this is a positive development and heralds an era of even more accessible and sophisticated efforts to better prevent HIV, particularly in the most vulnerable communities.
Presented at this summer’s global conference, the study, presented by a pharmaceutical company specializing in treatments for HIV, is based on data from the continuous phase of the HIV Prevention Trials Network (HPTN) 084 study, which tested women living in sub-Saharan Africa form of PrEP. was examined. Africa.
In the study, this form of HIV prevention—compared to daily oral PrEP in pill form—was administered every eight weeks to 3,224 cis women at increased risk of HIV.
There was an initial phase in the study in which oral PEP tablets were administered to assess “the tolerability of cabotegravir prior to administration” of the injections. According to a press release, the study opened for registration in November 2017 and was conducted at research centers in Botswana, Kenya, Malawi, South Africa, Eswatini, Uganda and Zimbabwe.
Cabotegravir LA injection was shown to be superior to daily oral PrEP in preventing HIV in a study population of women.
In data presented at the conference, this form of injectable PrEP resulted in an “89% lower rate of HIV acquisition” than treatment with oral tablets, the press release said.
When asked why the results of this study are important, Alex Rinehart, PhD, director of medical development, HIV prevention at VIV Healthcare said these results “reinforce the potential” of such an injectable HIV prevention.
He told Healthline that “these new findings” show that cabotegravir LA for PrEP “significantly reduces the incidence of HIV” while maintaining “superiority” over daily oral tablets.
Additionally, he said the new safety data released by the company indicated no birth defects in women who became pregnant after being exposed to a first injection of this type of PrEP treatment.
dr Monica Gandhi, MPH, professor of medicine and Associate Division Chief (Clinical Operations/Education) of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/San Francisco General Hospital said at this year’s HIV/AIDS conference: One in eight long effective PrEP with intramuscular cabotegravir over the week was in the news.
She told Healthline that this test is featured in cis women in both research and the HPTN 083 study, which also looked at this type of PrEP given to men and trans women to have sex with men.
When it came to this study, Gandhi, who was not involved with this research or with VIV Healthcare, stated that injectable PrEP given every eight weeks showed “a 66% reduction in HIV incidence compared to oral PrEP.” was better” during the cabotegravir leg study than with oral PrEP administration.
ViiV Healthcare’s Rinehart said it should be made clear that “both injectable and oral PrEP significantly reduce the risk of contracting HIV through sex when taken as directed.”
“But daily oral adherence and uptake of PEP can be limited by a number of factors, including side effects, convenience and stigma. As no single drug is right for everyone under all circumstances, it is important to ensure that people can benefit from PEP and are aware of the options available to meet their evolving needs,” he said.
Pending regulatory approval and access, Rinehart notes that cabotegravir LA for PrEP suggests a method of HIV prevention that is less cumbersome and intimidating for people than taking a daily pill. It seems.
When asked who might benefit, he said it has universal implications for communities at risk of HIV because it can be given to adults and youth at risk of HIV through sexual transmission and in pill form. With PrEP, the test results show HIV negative “before starting”.
“Many people who are susceptible to HIV have complex lives that can burden taking the pill to prevent HIV every day. These include stigma, fear of accidental exposure to their medications, and general complications from everyday life. could be involved,” Rinehart explained. “Taken together, these issues may contribute to low rates of PrEP use and the spread of the HIV epidemic.”
He stressed that it was important to note the “improved effectiveness” in preventing HIV transmission, showing that this form of PrEP “is appropriate for populations that are vulnerable and at risk of contracting HIV.” as shown in both studies. Transgender women, cisgender men, and cisgender women who have sex with men.
“With the availability of cabotegravir LA for PrEP as an injection every two months to prevent HIV, people have an important new option on top of their daily medication,” Rinehart said. “A daily HIV prevention pill option that reduces dosing days from 365 to six times a year could potentially have a significant impact on efforts to end the pandemic.”
The two studies paint a more comprehensive picture of who can benefit from such HIV prevention. While the HPTN 084 study looked at cisgender women in sub-Saharan Africa, the other study, HPTN 083, was based in the US and included “Black/African American and Hispanic” communities of transgender women and cis men who have sex had with men. were involved. The population is particularly affected by the ongoing HIV/AIDS epidemic.
Back in July, shortly before the 2022 International AIDS Conference, the World Health Organization (WHO) issued new guidelines on this form of injectable PrEP treatment. In it, WHO urged countries around the world to consider this form of HIV prevention for those most at risk.
dr Meg Doherty, director of WHO’s global HIV, hepatitis and sexually transmitted infection programmes, said in a WHO press release: “The long-acting cabotegravir is a safe and highly effective agent for HIV prevention but has yet to be available outside of trials. Not there.” , “We hope these new guidelines will help accelerate the nation’s efforts to schedule and distribute CAB-LA along with other HIV prevention options, including oral PrEP and dapavirine vaginal rings.”
Both Gandhi and Rinehart are encouraged that a better understanding of the effectiveness of this form of PrEP will help improve HIV prevention and reach more people, particularly in vulnerable communities.
Gandhi said the study, which only covers cisgender women, was “groundbreaking for the world”.
“Given that PrEP injections should only be given six times a year, eliminating the need for the daily pill, this WHO recommendation has the potential to broadly support biomedical prevention efforts around the world,” she said. .
Rinehart said that “of the approximately 1.2 million people in the US who could benefit from PrEP, less than 25% are currently taking oral PrEP daily.”
This reality underscores why more and more options need to be available and accessible.
He explained that PrEP, like contraception, “will never be a one-size-fits-all approach, but rather a choice of a method that best suits your current needs.”
“An injectable PrEP alternative could play an important role in reducing HIV transmission and helping end the HIV epidemic,” Rinehart said.