Apretude

Apretude is the brand name for cabotegravir, a long-acting injectable antiretroviral medication approved for HIV pre-exposure prophylaxis (PrEP). Cabotegravir is an integrase strand transfer inhibitor (INSTI) that blocks HIV replication. Apretude is indicated to reduce the risk of acquiring HIV-1 infection in adults and in certain at-risk adolescents, in combination with HIV testing and counseling, and is not intended for treatment of HIV infection. It should not be used if HIV infection is present.

Dose and administration: Apretude is given as a deep intramuscular injection into the gluteal muscle. The regimen begins with two initial injections given about one month apart, followed by injections every two months. Dosing requires regular healthcare visits for administration; patients should be monitored for adverse reactions and HIV testing prior to initiation and at intervals during use.

Effectiveness: In large clinical trials, cabotegravir PrEP demonstrated high efficacy in preventing HIV infection and was more effective than the standard daily oral TDF/FTC PrEP among diverse populations including men who have sex with men, transgender women, and heterosexual women.

Safety and side effects: The most common adverse events are injection-site reactions such as pain, swelling, or redness at the injection site, typically lasting a few days. Other frequent events include headaches, fatigue, and sleep disturbances. Serious adverse events are uncommon but can include hypersensitivity reactions and the potential for HIV drug resistance if infection is not ruled out before starting or if injections are delayed for extended periods. Ongoing HIV testing and risk-reduction measures are recommended during use.

Regulatory status: Apretude received FDA approval in December 2021 and has been incorporated into PrEP guidelines as a long-acting option; availability varies by country.