Cabotegravir in the treatment and prevention of Human Immunodeficiency Virus-1. (3rd April 2018)

• Record Type: Journal Article
• Authors: McPherson, Tristan D.; Sobieszczyk, Magdalena E.; Markowitz, Martin
• Is Part Of: Expert opinion on investigational drugs. Volume 27:Number 4(2018)
• Page Start: 413
• Page End: 420
• Publication Date: 2018-04-03
• Subjects: Cabotegravir -- long-acting -- HIV-1 treatment -- integrase stand transfer inhibitor -- HIV-1 pre-exposure prophylaxis; Drugs -- Design -- Periodicals; Drugs, Investigational -- Bibliography; Drugs, Investigational -- Periodicals; 615.1
• DOI: 10.1080/13543784.2018.1460357
• Languages: English
• ISSNs: 1354-3784

Abstract

ABSTRACT: Introduction: Human Immunodeficiency Virus (HIV) is a chronic infection that depletes the immune system of essential components causing those infected to be at risk for multiple life-threatening infections. Worldwide, millions live with this infection, the vast majority attributable to HIV-1. Transmission persists with hundreds of thousands of new infections reported yearly. Implementation of combination antiretroviral therapy (cART) has been effective in improving outcomes and decreasing transmission. Newer co-formulated agents have provided simpler medication regimens, fewer side effects, and, in some cases, a higher barrier to the emergence of medication resistance. Areas covered: Here, we review trials of cabotegravir (CAB) as treatment of HIV-1 infection and its potential use as pre-exposure prophylaxis (PrEP) in high risk individuals, including issues around oral lead in and potential resistance emergence. Expert opinion: CAB is efficacious when used in combination therapy orally or given intramuscularly every 4 to 8 weeks. Its availability in a long-acting injectable formulation (CAB-LA) makes it a valuable, novel drug to treat HIV-1 infection when combined with long-acting injectable rilpivirine (RPV-LA). Moreover, pre-clinical and early Phase 2a studies support its testing as monotherapy as PrEP. Studies are underway comparing the efficacy of every 8 week CAB-LA to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC).