There were no new data of note regarding long-acting injectable antiretroviral therapy this year, but this important advance in treatment continues to move closer to reality. The results of the LATTE trial demonstrated that oral rilpivirine and a dolutegravir-like integrase inhibitor in development could maintain viral suppression as well as continued therapy with tenofovir/emtricitabine/efavirenz. A follow-up study of this approach, using the injectable versions of these two medications administered every two months, is now underway. Assuming this study also demonstrates safety and efficacy, the buzz regarding this approach will grow into a roar.
At first glance, long-acting injectable antiretroviral therapy, given every two to three months, would seem ideal for the nonadherent. Then again, do you want to be chasing down a patient who has missed his last two scheduled shots and has slowly falling levels of HIV drugs with relatively modest barriers to drug resistance? Will injections be administered in only clinical settings or local pharmacies? Can health departments get in on the act? What about using these drugs for PrEP?
These and other questions will need answering, hopefully before the drugs come to market. Word is slowly getting out. Long-acting antiretroviral therapy is coming. Be prepared. Be very prepared.