Cabenuva

Cabenuva is a brand-name HIV-1 treatment that combines two long-acting injectable antiretroviral drugs, cabotegravir and rilpivirine. It is designed as a complete, two-drug regimen for maintaining viral suppression in adults and, where indicated, certain adolescents who are already virologically suppressed on a stable antiretroviral therapy.

Mechanism and composition: Cabotegravir is an integrase strand transfer inhibitor, and rilpivirine is a non-nucleoside reverse transcriptase inhibitor. When given as a long-acting injectable, the two drugs are administered together as separate injections into the gluteal muscles by a healthcare professional.

Administration and dosing: Treatment with Cabenuva is given after an initial lead-in period with oral formulations to assess tolerability in many cases. Following the lead-in, injections are administered at regular intervals (commonly monthly) to maintain viral suppression. If doses are missed or delayed for extended periods, there is a risk of virologic rebound and potential development of resistance.

Indications and limitations: Cabenuva is indicated for people who have achieved virologic suppression on a stable regimen and who do not have known resistance to either cabotegravir or rilpivirine. Before starting, clinicians assess baseline HIV resistance and other safety considerations. It is administered only in a clinical setting due to the need for injections and monitoring.

Safety and adverse effects: The most common adverse events are injection-site reactions. Other possible effects include fever, fatigue, headache, rash, and sleep disturbances. As with all antiretrovirals, drug interactions and individual contraindications must be reviewed.

See also: long-acting antiretroviral therapy, integrase inhibitors, non-nucleoside reverse transcriptase inhibitors.