A RECENT study at a Ryan White-funded clinic in the U.S. South highlights the effectiveness of long-acting antiretroviral therapies (LA-ART) in achieving viral suppression among individuals with HIV-1 viremia. This cohort of 81 people with HIV (PWH), most of whom had struggled with viremia despite standard oral antiretroviral therapy (ART), received a regimen including cabotegravir/rilpivirine (CAB/RPV), with additional agents such as lenacapavir (LEN) or ibalizumab (IBA) for some. The results underscore the potential of LA-ART in populations facing significant barriers to care.
Of the 79 participants who remained in follow-up, 92% achieved viral suppression after a median of one LA-CAB/RPV injection. In addition to viral load suppression, participants also experienced an increase in CD4+ counts, rising from a median of 186 cells/μL to 353 cells/μL. The on-time administration rate for LA-ART was strikingly high, with 98% of injections being delivered as scheduled.
This retrospective study highlights the critical role of LA-ART in improving health outcomes among PWH in regions with the highest HIV burden, particularly in the Southern U.S. Despite demographic and socio-economic challenges, including a predominance of Black participants (93%) and a significant portion of women (40%), the intervention proved successful in reaching key health milestones. The findings emphasize that long-acting therapies can be a vital tool for achieving the goals of Ending the HIV Epidemic initiative.
While the majority of participants responded well to treatment, the study also noted some instances of virologic failure, with two participants developing drug resistance and others showing persistent viremia. These results suggest the need for continued monitoring and potential adjustments in treatment regimens for certain individuals.
With a promising 92% success rate, this study provides a clear example of how LA-ART can be leveraged to combat HIV in high-burden areas and contribute to broader public health goals.
Reference:
Colasanti JA et al. Long-acting cabotegravir/rilpivirine, lenacapavir, and ibalizumab use among persons with HIV-1 viremia at a Ryan White-funded clinic in the urban U.S. South. Clin Infect Dis. 2025:ciaf425.
