Efficacy of a 9-Month Oral Treatment Regimen for Rifampicin-Resistant Tuberculosis
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on July 12th, 2024
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According to the current recommendations of the World Health Organization, daily oral antiretroviral therapy, which includes tenofovir disoproxil fumarate, lamivudine, and dolutegravir, is used to manage HIV infection. This method has been effective in controlling HIV in resource-poor countries, although it requires strict adherence to the medication schedule. Long-acting therapy with cabotegravir and rilpivirine has shown high efficacy in trials conducted in Europe and North America. A recent article published in The Lancet compared the effectiveness of long-acting cabotegravir and rilpivirine therapy with the standard oral therapy in managing HIV.
The study was conducted in Kenya, Uganda, and South Africa, including 512 participants who had maintained an HIV viral load below 50 copies per mL for at least 4 months before the study began. These participants had been using antiretroviral therapies such as tenofovir disoproxil fumarate, lamivudine, emtricitabine, nevirapine, efavirenz, or dolutegravir within the past 6 months. The study excluded those with 2 or more consecutive viral load tests above 200 copies per mL and those with previous or active hepatitis B infection. Participants were randomly assigned to receive either the standard oral therapy or the long-acting therapy. Those in the oral therapy group followed the WHO-recommended regimen of 300 mg of tenofovir disoproxil fumarate, 300 mg of lamivudine, and 50 mg of dolutegravir. The long-acting therapy group initially took 30 mg of cabotegravir and 25 mg of rilpivirine daily for 4 weeks to assess drug tolerance, followed by intramuscular injections of 600 mg of cabotegravir and 900 mg of rilpivirine every 8 weeks. After 48 weeks, both groups - daily oral and long-lasting injection - had a similar percentage of participants with viral loads below 50 copies per mL, around 96%. In addition to its equally high efficacy, many may prefer long-acting injections because it reduces the need to carry medication, remember daily doses, and alleviate anxiety about being discovered as HIV-positive from the pills they are taking.
The study was conducted in Kenya, Uganda, and South Africa, including 512 participants who had maintained an HIV viral load below 50 copies per mL for at least 4 months before the study began. These participants had been using antiretroviral therapies such as tenofovir disoproxil fumarate, lamivudine, emtricitabine, nevirapine, efavirenz, or dolutegravir within the past 6 months. The study excluded those with 2 or more consecutive viral load tests above 200 copies per mL and those with previous or active hepatitis B infection. Participants were randomly assigned to receive either the standard oral therapy or the long-acting therapy. Those in the oral therapy group followed the WHO-recommended regimen of 300 mg of tenofovir disoproxil fumarate, 300 mg of lamivudine, and 50 mg of dolutegravir. The long-acting therapy group initially took 30 mg of cabotegravir and 25 mg of rilpivirine daily for 4 weeks to assess drug tolerance, followed by intramuscular injections of 600 mg of cabotegravir and 900 mg of rilpivirine every 8 weeks. After 48 weeks, both groups - daily oral and long-lasting injection - had a similar percentage of participants with viral loads below 50 copies per mL, around 96%. In addition to its equally high efficacy, many may prefer long-acting injections because it reduces the need to carry medication, remember daily doses, and alleviate anxiety about being discovered as HIV-positive from the pills they are taking.