Long-acting injectable cabotegravir (CAB-LA) is an antiretroviral drug to prevent HIV infection – as pre-exposure prophylaxis (PrEP) to this virus – that was approved a long time ago by the EU, and that will now be used in 90 low- and middle-income countries where the majority of new infections occur, thanks to an agreement promoted by Unitaid, a global health agency dedicated to finding innovative solutions to prevent, diagnose and treat diseases more quickly, cheaply and effectively in countries with lower incomes.
This deal comes a day after the publication of an AIDS report warning that efforts to prevent HIV infection had stalled as more resources had been devoted to controlling the COVID-19 pandemic. 19 and that in 2021 there had been 1.5 million new infections, the same as in 2020. In 2021, 4,000 new infections were registered every day, the majority in certain sectors of the population, such as sex workers, men who have sex with men, injecting drug users, transgender people, people in prison, and their sexual partners, who make up 70% of global HIV infections.
The alliance for the granting of voluntary patent licenses related to long-acting cabotegravir will facilitate access to generic formulations of the drug in the least developed and low- and lower-middle-income countries and those in sub-Saharan Africa (the epicenter of the epidemic of HIV), where the HIV infection rate of adolescent girls aged 15 to 19 in sub-Saharan Africa is six times higher than that of their male peers.
The WHO has added injectable cabotegravir in its new guidelines
The World Health Organization (WHO) has also recommended that long-acting cabotegravir be used for HIV prevention. The new health agency guidelines advise countries to administer this drug “as part of a comprehensive approach to HIV prevention” and ask them to consider this safe and highly effective prevention option for people at significant risk of HIV infection. infection.
To work as pre-exposure prophylaxis, the first two intramuscular injections of cabotegravir long-acting injection are given 4 weeks apart, followed by a schedule of one injection every 8 weeks thereafter. Two randomized trials (HPTN 083 and HPTN 084) of the drug showed cabotegravir to be safe and highly effective in cisgender women, cisgender men who have sex with men, and transgender women who have sex with men. This treatment was found to achieve a 79% relative reduction in the risk of HIV infection compared to daily oral pre-exposure prophylaxis, which has problems with user compliance.
WHO “will support countries and partners to safely and effectively include CAB-LA in HIV prevention programmes.” This agency believes that both oral PrEP and CAB-LA are very effective, and that CAB-LA increases the options available to prevent HIV and should always be offered along with oral PrEP, because some people may prefer oral PrEP, but those who find it difficult or don’t want to take pills are likely to prefer CAB-LA.
Two months of continuous protection against HIV
Unitaid spokesman Herve Verhoosel said: “This is a very effective method of HIV prevention, but until recently it was only available as a pill, taken daily or, in some cases, before and after. sexual intercourse”. He adds that long-acting injectable cabotegravir is an important advance, “because it can provide two months of continuous protection against HIV infection through a single intramuscular injection, thereby reducing problems related to pill overload.”
Long-acting injectable cabotegravir is an important advance, “because it can offer two months of continuous protection against HIV infection through a single intramuscular injection”
The agreement between the Medicines Patent Pool and ViiV Healthcare will allow a group of manufacturers to develop, manufacture and supply generic versions of cabotegravir LA for PrEP in 90 countries where more than 70% of all new HIV infections occurred in 2020.
“Advances in access to cabotegravir LA for PrEP will particularly affect groups with particularly high infection rates, such as men who have sex with men, sex workers, transgender women, adolescent girls and young women” Verhoosel said. Unitaid is funding part of the first large-scale implementation of cabotegravir LA in South Africa and Brazil, to ensure that this prophylaxis reaches populations in resource-poor areas as soon as possible.
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