A clinical trial involving adolescents in four African countries has found that HIV injections given every eight weeks may control the virus more effectively than daily tablets, while offering young people a more convenient treatment option.
Long-acting HIV injections given every eight weeks kept the virus suppressed more effectively than daily tablets among adolescents in an African clinical trial, according to a study published in The Lancet. Researchers from University College London (UCL) said the findings support wider access to injectable treatment, particularly in low- and middle-income countries.
The Long-Acting Treatment in Adolescents (LATA) trial involved 476 adolescents aged 12 to 19 across five clinics in Kenya, South Africa, Uganda and Zimbabwe. Participants were randomly assigned to receive either daily antiretroviral tablets or injections containing cabotegravir and rilpivirine.
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After 96 weeks, only two adolescents, or 1 per cent, in the injectable group experienced confirmed viral rebound, compared with 15, or 6 per cent, among those taking daily tablets. Viral rebound occurs when the amount of HIV in the blood rises after previously being suppressed.
Nearly 94 per cent of adolescents receiving injections said treatment every eight weeks was much easier than taking medicines daily. Researchers noted that daily pills can create challenges linked to stigma, bullying and maintaining regular treatment routines.
Professor Sarah Pett, chief investigator of the trial at UCL, said, “Long-acting injectables taken every two months can help young people to lead a more normal life.”
The study also highlighted significant barriers to wider access. Injectable medicines are more expensive than standard tablets, require specialised healthcare workers and, in the case of rilpivirine, need refrigeration during storage and transportation.
Dr Deborah Ford of UCL said limited access to injectable treatments in Africa could increase inequalities in HIV care. She warned that most people living with HIV in the region remain unable to access treatments available in wealthier countries.
The World Health Organization currently recommends long-acting injectables as an alternative for eligible adolescents and adults who have achieved viral suppression. Researchers called for greater availability of the treatment in Africa, where the majority of adolescents living with HIV reside.
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