Cabotegravir for HIV Prevention in Cisgender Men and Transgender Women
RCT (n=1698 in US) stopped early for efficacy reports long-acting injectable cabotegravir (600mg IM 8 weekly) was superior to daily oral tenofovir disoproxil fumarate–emtricitabine (TDF–FTC) in preventing HIV infection in this population (HR 0.34; 95 CI, 0.18 to 0.62).
Source:
New England Journal of Medicine
SPS commentary:
HIV infections occurred in 52 participants: 13 in the cabotegravir group (incidence, 0.41 per 100 person-years) and 39 in the TDF–FTC group (incidence, 1.22 per 100 person-years)
According to an editorial, injectable cabotegravir provides a new option for MSM and transgender women who have sex with men starting PrEP, and is likely to increase PrEP uptake, as the injection is well suited to persons who are unable to adhere to a daily tablet regimen. It adds that PrEP coverage needs to increase substantially to achieve the worldwide goal for reducing HIV infection and as an initial step in this direction, real-world implementation studies of injectable cabotegravir could explore multiple approaches to increase PrEP coverage, especially if the companion efficacy trial (HPTN 084) of injectable cabotegravir that is currently under way in women in Africa shows similar promising results.