NICE backs first long-acting injectable treatment for HIV

Thousands of people could be offered a long-acting injectable treatment for HIV on the NHS for the first time under draft guidance published by NICE.

Tube containing blood sample
Blood test: HIV-1 injectable treatment available (Photo: Andrew Brookes/Getty Images)

In draft advice published on 18 November NICE backed the use of cabotegravir with rilpivirine - the first long-acting injectable treatment for HIV-1 infection in adults.

Use of the drugs is recommended as an option for adults with HIV-1 infection in whom levels of the virus have been kept at a low level by antiretroviral medications they are already taking, and where there is 'no evidence to suspect viral resistance' and no previous failure of other anti-HIV-1 medicines - nonnucleoside reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (INIs).

Estimates suggest around 13,000 people could be eligible for treatment with cabotegravir (also known as Vocabria) with rilpivirine (also known as Rekambys) in England alone.

Clinical trials have shown that the drug combination 'as effective as oral antiretrovirals' at keeping viral loads at low levels - below 50 copies/ml of blood, a level considered so low it cannot be detected or transmitted between people.

Injectable HIV treatment

Treatment with cabotegravir and rilpivirine would see the drugs administered as two separate intramuscular injections every two months, after initial treatment with oral tablets.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Assessment at NICE, said: 'Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment.

'However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle. The committee heard that stigma remains an issue for people living with HIV and can have a negative impact on people’s health and relationships.

'We’re pleased therefore to be able to recommend cabotegravir with rilpivirine as a valuable treatment option for people who already have good levels of adherence to daily tablets, but who might prefer an injectable regimen with less frequent dosing.'

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