The mainstay of initial therapy for HIV remains integrase strand transfer inhibitor-containing regimens, according to a special communication published in JAMA in which Rajesh T. Gandhi, MD, and colleagues updated 2020 consensus recommendations relating to ART for the treatment and prevention of HIV. Long-acting injectable therapy with cabotegravir plus rilpivirine given as
infrequently as every 2 months is now an option for people who have achieved viral suppression with a daily oral regimen. Because people with HIV are living longer and experiencing health challenges related to aging, managing comorbidities is increasingly important, according to Dr. Gandhi and colleagues. Certain ART regimens have also been linked to weight gain and metabolic complications; novel strategies are needed for these complications. Further, PrEP options include oral medications, as well as a long-acting injectable agent, cabotegravir, for the first time. An equity-based approach is essential to address challenges, including global health emergencies like COVID-19 and monkey pox. “Advances in treatment and prevention of HIV continue to improve outcomes, but challenges and opportunities remain,” Dr. Gandhi and colleagues wrote.
