Full engagement in care, viral suppression seen among youth with HIV

A recent study has shown 100-percent engagement in care and viral suppression among 25 adolescents and youth with HIV (AYHIV) being treated with long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) during follow-up.

Of the AYHIV (median age 19 years, median BMI 25.3 kg/m², 48 percent were cisgender females), 64 percent acquired HIV perinatally, and 53 percent had viral suppression for ≥6 months. They received LAI CAB/RPV for a median duration of 11.8 months.

Twenty-four AYHIV (96 percent) initiated monthly LAI CAB/RPV injections, and 19 (76 percent) switched to bimonthly injections.

Transient viraemia episodes (1–5 per person; ranges, 48–1,100 copies/mL) occurred in seven AYHIV, with most (78 percent) taking place within the initial 12 months. However, these episodes resolved at retesting after 3 to 91 days, none of which led to CAB or RPV resistance. 

Injection-related pain or discomfort was mild to moderate and decreased over time. Grade 2 adverse events were self-resolved, including three AYHIV with postinjection adverse reactions and one with QTc prolongation. Additionally, three cisgender female AYHIV got pregnant and continued using LAI CAB/RPV. No discontinuations, missed, or delayed injections were reported.

Notably, all AYHIV achieved viral suppression at the end of the study follow-up.

"More data are needed to evaluate the long-term outcomes and sustainability of LAI CAB/RPV treatment in AYHIV,” the authors said. 

This observational study involved AYHIV <25 years who initiated LAI CAB/RPV from October 2021 to June 2024 as a standard of care. The authors collected data on demographics (age, race/ethnicity, and gender/sexual orientation), BMI, HIV history, efficacy (CD4, HIV RNA, and resistance), safety, and retention in care.