Long-Acting HIV Treatment: Current and Future Options

Purpose of ReviewLong-acting antiretrovirals have become of increasing interest over the past years as they address unmet needs in antiretroviral treatment. While they seem an intuitive option for people with challenges with adherence to daily oral antiretroviral therapy, they might also contribute to the well-being of other groups of people living with HIV by addressing issues such as fear of disclosure, pill fatigue, and the daily reminder of a person's HIV status. This review aimed to summarize current and future options in long-acting antiretroviral therapies.Recent FindingsCabotegravir & Rilpivirine are currently the only available full non-daily, non-oral treatment regimen. Some other long-acting drugs exist, including Albuvirtide, Ibalizumab, and Lenacapavir, but they are approved as add-on therapies to a (failing) antiretroviral therapy and therefore are not an alternative to 'standard' regimens. Other long-acting drugs are under development. Besides intramuscular application, subcutaneous injections but also less frequently dosed oral antiretrovirals are being investigated. Many long-acting therapy studies with 'outdated' drugs have been reported and might be more seen as a proof of concept than a true attempt to achieve approval for the use in humans.SummaryLong-acting antiretroviral treatments seem to address unmet needs of people living with HIV. While currently, only an intramuscular complete long-acting regimen is available, other routes of application and other drugs are under development. The role of long-acting treatments for a broader population will depend on the possibility of extending criteria for eligibility, progress in application intervals, costs compared to daily treatment, and safety, amongst others.