March 20, 2026
When long-acting HIV therapy fails, what can we learn?
A new study from experts within EACS analyses the first ~100 reported cases of virological failure with long-acting cabotegravir/rilpivirine (CAB/RPV-LA).
The key takeaway: failure remains rare, but when it occurs it is often associated with emergent resistance, sometimes affecting future treatment options. RPV or CAB levels at failure were often low; however, similar low levels are sometimes also observed in successfully treated individuals, highlighting the complexity of interpreting drug concentrations.
As long-acting antiretroviral therapies become more widely used, continued monitoring of resistance patterns and viral subtypes will be critical.
Congratulations to the authors Maria Mazzitelli, Milosz Parczewski, David Burger, and Annemarie Wensing for this important contribution.
Published in Clinical Infectious Diseases
https://bit.ly/VirologicalFailure
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciag046/8508656?login=false