Modifying Antiretroviral Therapy in Virologically Suppressed HIV-Infected Patients

  • Author: José R. Arribas, MD (More Info)
  • Section Editor: Eric S. Daar, MD
  • Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
  • Last Reviewed: 10/18/21 (What's New)


  • Cabotegravir is an HIV INSTI that is approved by the FDA as an oral formulation to be used with oral rilpivirine and coformulated with rilpivirine long acting (LA) as an LA nanosuspension
  • Two phase III studies (ATLAS and FLAIR) have assessed the efficacy and safety of injectable cabotegravir plus rilpivirine LA in virologically suppressed patients
  • In ATLAS, patients on stable ART with HIV-1 RNA < 50 copies/mL for ≥ 6 months with no previous virologic failure were randomized to switch to monthly intramuscular injections of cabotegravir plus rilpivirine LA (following a short lead-in with oral formulations of both drugs) or continued baseline ART.[Swindells 2020] At Week 48, rates of virologic nonresponse were similar between study arms: 1.6% vs 1.0% in switch patients vs nonswitch patients, respectively[Swindells 2020]

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