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Treatment

The Future of HIV Treatment—and PrEP: Long Acting Injectables

2003 file photo of Dr David Ho
2003 file photo of Dr David Ho

Renowned HIV Researcher Dr. David Ho say injectables take human error out of the mix.

Dr. David Ho — TIME Magazine's 1996 Person of the year, and one of the people who launched the era of HIV-suppressing, highly active antiretroviral treatment—addressed the 2016 United States Conference on AIDS, talking about the next critical step in HIV treatment.

"If you take the drugs they work, it you don’t they don’t work." Ho said, simplifying the problem with nonadherence. "Long acting agents will take human behavior out of the equation."

"How do you administer long-lasting antiretrovirals administered to high risk individuals?" He asked rhetorically, before spelling out the answers: One: he said, through potent and broad virus-neutralizing monoclonal antibodies. Two: through slow-release formulationof antiretroviral drugs. "Cabotegravir (GSK 744) is a potent integrase inhibitor of HIV. This drug has unusual physical properties: a high melting point, low water solubility, high potency, low metabolic clearance, and can be put into an injectable."

Plus reported on the 12-16 weeks injectable last week.  In the findings from the World AIDS Conference in Durban it was found that injectables could be used as long acting agent.

"Will this be protective against HIV infection?" Dr. Ho wondered, considering the potential of a long-acting PrEP. Recent experiments to answer that question involved 16 monkeys, divided into two groups. Both were exposed to the simian version of the HIV virus rectally. One group was injected with Cabotegravir, and, among them, there were no HIV infections a the eight-week point. In a related intravaginal study, six out of eight monkeys did not acquire SIV upon exposure when using the drug. Ho summarized the findings regarding using Cabotegravir as a long-acting PrEP agent: 

"It proves highly protective against intrarectal, intravaginal, and intravenous virus challenges in monkey studies." They have already completed Phase 1 and Phase 2 human studies. So far, "over 1000 subjects having received the drug; and they have an outstanding tolerability profile and none to minimal side effects."  

Several Phase 3 studies to measure protective efficacy anticipated in different high-risk populations, (gay men and black women) will begin soon.

Long-acting injectables are the future of HIV treatment and prevention. And that is good news, indeed.
 

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Damon L. Jacobs

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Ryan is the Digital Director of The Advocate Channel, and a graduate of NYU Tisch's Department of Dramatic Writing. She is also a member of GALECA, the LGBTQ+ society of entertainment critics. While her specialties are television writing and comedy, Ryan is a young member of the LGBTQ+ community passionate about politics and advocating for all.

Ryan is the Digital Director of The Advocate Channel, and a graduate of NYU Tisch's Department of Dramatic Writing. She is also a member of GALECA, the LGBTQ+ society of entertainment critics. While her specialties are television writing and comedy, Ryan is a young member of the LGBTQ+ community passionate about politics and advocating for all.