Monthly anti-HIV injections outperform daily pills in trial

Long-lasting injections that provide a slow and continuous release of drugs could soon replace daily pill-based antiretroviral therapy (ART) for HIV patients following a successful two-year-long clinical trial, researchers announced Monday at the IAS Conference on HIV Science.

According to BBC News and New Scientist, the trial determined that injections taken once every four to eight week were just as effective as the daily ART pills, with 94% of the 286 participants reporting that their HIV was under control (defined as having less than 50 copies of the virus per milliliter of blood) after receiving one injection of the long-lasting therapy every two months.

Furthermore, a monthly form of the injection was shown to be effective in 87% of HIV patients who received it, the researchers said. In comparison, standard ART pills worked for just 84% of recipients, University of North Carolina researcher Dr. Joseph Eron announced at the event.

Each group experienced similar side effects, including diarrhea and headaches, BBC News said. The two-year trial was conducted at 50 different medical facilities in Canada, France, Germany, Spain and the US, and was funded by the injections manufacturer, ViiV Healthcare. A long-term trial designed to confirm the result is already underway, according to reports.

‘A big step forward’ in treating the virus, say experts

Participants in the study were given either traditional, pill-based ART treatment or the injection, a suspension of the antiretroviral drugs cabotegravir and rilpivirine, in their buttocks once every month or two for the duration of the 96-week trial, New Scientist and BBC News noted. Results of the trial have been published in the British medical journal The Lancet.

“Adherence to medication remains an important challenge in HIV treatment,” lead author Dr. David Margolis told BBC News. “The introduction of single tablet medication represented a leap forward in antiretroviral therapy. Long-acting antiretroviral injections may represent the next revolution in HIV therapy by providing an option that circumvents the burden of daily dosing.”

One dose of the injection “can last for 48 weeks or more,” as it gathers between muscle fibers and slowly leaks out into the patient’s blood stream, Peter Williams of the pharmaceutical firm Janssen (which helped lead the study) told New Scientist. Only two of the participants dropped out of receiving the injection, and while a few reported some soreness at the injection site, most said that they preferred receiving the injections to taking pills, he added.

The success of the injection in this small-scale clinical trial is the latest breakthrough in the fight against HIV, which infects more than 36 million people worldwide but – thanks to advances that have been made since 2005 – now only kills around one million per year (half the number that it used to claim, according to BBC News). However, a patient diagnosed at the age of 20 could end up taking as many as 20,000 ART pills during his or her lifetime, the UK media outlet noted.

Currently, only a little over half of those infected with the virus globally would have access to the injection. Nonetheless, as Mahesh Mahalingam of the UN Program on HIV/AIDS told New Scientist, the injection’s success is “a big step forward. It will help remove the challenge of taking tablets every day and significantly improve the quality of life of people living with HIV.”


Image credit: David Goldman/The New York Times/Eyevine