Case 12. Injectable ART Failure: Minor Risk of a Major Event

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Viremic – Cases in HIV

Dr. Eileen Scully & Dr. Christopher Hoffmann

14 episodes

23 hours ago

Hosted by Eileen Scully, MD, PhD, and Christopher Hoffmann, MD, MSC, MPH, both HIV specialists at Johns Hopkins, Viremic explores quandaries in adult HIV care. Each case discussion includes medical history and diagnoses, challenges in care and treatment, and key evidence and guidelines that informed clinical decision‑making. All clinical discussions presented on Viremic are for informational purposes only and are not offered as medical or clinical practice advice for patients or clinicians. Viremic is produced by the Clinical Guidelines Program, a collaborative effort of the New York State Department of Health AIDS Institute and the Johns Hopkins University Division of Infectious Diseases.

All content for Viremic – Cases in HIV is the property of Dr. Eileen Scully & Dr. Christopher Hoffmann and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.

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Case 12. Injectable ART Failure: Minor Risk of a Major Event

Viremic – Cases in HIV

29 minutes

4 weeks ago

Case 12. Injectable ART Failure: Minor Risk of a Major Event

After 3 years on injectable CAB/RPV, a patient develops viremia, with a viral load of ~1,300 copies/mL. Failure of injectable CAB/RPV occurs in 1% to 2%, despite adherence. What factors have been associated with CAB/RPV failure? Can regimen failure be predicted or prevented? Listen as Chris and Eileen discuss the data, their advice to patients considering a switch to injectable CAB/RPV, and their response when failure occurs.

References Cited:

Orkin C., Arasteh K., Gorgolas Hernandez-Mora M., et al. Long-acting cabotegravir and rilpivirine after oral induction for HIV-1 infection. N Engl J Med 2020;382(12):1124-35. PMID: 32130806.
Overton E. T., Richmond G., Rizzardini G., et al. Long-acting cabotegravir and rilpivirine dosed every 2 months in adults with human immunodeficiency virus 1 type 1 infection: 152-week results from ATLAS-2M, a randomized, open-label, phase 3b, noninferiority study. Clin Infect Dis 2023;76(9):1646-54. PMID: 36660819.
Swindells S., Andrade-Villanueva J. F., Richmond G. J., et al. Long-acting cabotegravir and rilpivirine for maintenance of HIV-1 suppression. N Engl J Med 2020;382(12):1112-23. PMID: 32130809.
van Welzen BJ, Van Lelyveld SFL, Ter Beest G, et al. Virological Failure After Switch to Long-Acting Cabotegravir and Rilpivirine Injectable Therapy: An In-depth Analysis. Clin Infect Dis. 2024 Jul 19;79(1):189-195. PMID: 38207125.

Related Guideline:

NYSDOH AI: Use of Injectable CAB/RPV LA as Replacement ART in Virally Suppressed Adults