Lancet: Preclinical evaluation of long-acting cabotegravir and rilpivirine for HIV post-exposure prophylaxis in a macaque model

Current PEP guidelines require 28 days of oral antiretroviral therapy, but adherence is often poor. This study tested whether a single injection of long-acting cabotegravir and rilpivirine (CAB LA/RPV LA) could work as PEP in macaques. Six macaques received the drugs 24 hours after a high-dose rectal RT-SHIV exposure and were compared to seven untreated controls. CAB LA/RPV LA provided partial protection: 4 of 6 treated macaques remained uninfected for 16 months, while 2 became infected, showing delayed viral detection and rilpivirine resistance. All controls were infected. Estimated efficacy was 66.7%, but with wide confidence intervals. Findings suggest that one-time CAB LA/RPV LA PEP can protect under stringent conditions, though delayed infections pose diagnostic challenges and require long-term follow-up.

The article is available at the following link: Preclinical evaluation of long-acting cabotegravir and rilpivirine for HIV post-exposure prophylaxis in a macaque model - eBioMedicine