Long-acting injectable HIV therapies: the next frontier

Purpose of review There has been significant development of long-acting injectable therapy for the management of HIV in recent years that has the potential to revolutionise HIV care as we know it. This review summarises the data and outlines the potential challenges in the field of long-acting antiretroviral therapy (ART). Recent findings In recent years, monthly and two monthly long-acting injectable ART in the form of cabotegravir and rilpivirine has shown safety and efficacy in large-scale phase 3 randomised control trials. Also, agents with novel mechanisms of action, such as Lenacapavir, have been tested in early-phase studies and are currently being tested in phase 2-3 clinical trials; if successful, this may allow six-monthly dosing schedules. Summary However, despite evidence that suggests that these therapies are efficacious and acceptable to patients, the challenge of integrating these agents into our current healthcare infrastructure and making these novel agents cost-effective and available to the populations most likely to benefit remains. The next frontier for long-acting therapy will be to introduce these agents in a real-world setting ensuring that the groups most in need of long-acting therapy are not left behind.

Automated summary

In recent years, long-acting injectable ART has shown safety and efficacy in large-scale phase 3 trials, with novel mechanisms of action being tested in early-phase studies. However, integrating these therapies into healthcare infrastructure and ensuring cost-effectiveness and availability for those who could benefit most remains a challenge. The next frontier for long-acting ART will be to introduce these agents in a real-world setting to ensure equitable access for those in need.