Question
What are injectables – or injectable ART?
23 August 2024. Related: All topics, Changing treatment, Injectable ART.
What are injectibles? Who is eligible for them? Do they make you ill? And what is the process of changing from taking pills to taking injectibles?
Answer
Hi there
Most HIV meds are daily oral pills – often with 2, 3 or 4 medicines in a single pill.
Although some HIV meds in the past have been given by injection, these have usually been to overcome HIV drug resistance.
Several years ago, a new HIV combination was approved that is given by two injections into the buttock muscle. One injection is an integrase inhibitor called cabotegravir (CAB-LA) and the other is an NNRTI called rilpivirine (RPV-LA).
It is generally given every two months and a nurse needs to give the injection.
Currently you can only switch to injections if your viral load has been undetectable on oral ART for at least six months.
You also probably need to have a good reason to want to use injections. This is because this treatments fails in a small percentage (1 to 2%) of people, even if they always have the injections.
The reasons for viral rebound in some people isn’t fully understood, and so can’t be predicted. More importantly, when viral load rebounds in these cases, it is often with drug resistance to both CAB-LA and RPV-LA. This often means that other drugs in these two classes will also be resistance.
This means changing to older HIV drugs that are not as modern or easy to tolerate.
These British HIV Association (BHIVA) guidelines are about who can use CAB/RPV injections.
https://i-base.info/qa/23767
General information about these meds are also at this link:
https://i-base.info/guides/15361
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