Injectable HIV Treatment Achieves 88% Viral Suppression in Patients with Adherence Challenges, IAS 2025 Reports

KIGALI, Rwanda – New research presented at the International AIDS Society (IAS) 2025 Conference indicates that long-acting injectable cabotegravir and rilpivirine, marketed as Cabenuva, offers a highly effective treatment option for individuals living with HIV who have struggled to maintain viral suppression on daily oral therapy. These findings underscore the expanding utility of long-acting antiretroviral regimens in addressing adherence challenges.

Cabenuva, developed by ViiV Healthcare, has typically been approved for individuals already virally suppressed on oral antiretroviral therapy. However, recent studies presented at IAS 2025, including data from the large real-world OPERA cohort, focused on its efficacy in a population facing difficulties with consistent daily pill intake. This represents a significant shift towards offering more flexible and patient-centric treatment solutions.

One key study from the OPERA cohort, presented at the conference, revealed that among 368 individuals who initiated injectable cabotegravir and rilpivirine with detectable viral loads, 88% achieved viral suppression (below 50 copies/mL). This success rate highlights the potential of the injectable regimen to overcome barriers such as adherence issues, which often lead to unsuppressed viremia. The IAS-USA treatment guidelines were updated in March 2024 to reflect this, recommending the consideration of injectable therapy for viremic patients with adherence difficulties, provided they receive intensive follow-up and case management.

The International AIDS Society, in a tweet, summarized these promising developments, stating, > "Long-acting #HIV treatment with injectable cabotegravir & rilpivirine (Cabenuva) may be a good choice for people who have been unable to maintain viral suppression on daily oral therapy, according to a pair of studies presented at #IAS2025." This sentiment was echoed by ViiV Healthcare, which also presented data from its VOLITION study, showing that 89% of eligible treatment-naïve individuals opted to switch to the long-acting injectable after achieving rapid viral suppression with oral therapy, citing reasons like not having to worry about missing a dose daily.

The implications of these findings are substantial for global HIV care, particularly for populations where daily pill adherence is a significant obstacle due to social determinants of health, stigma, or personal preferences. The shift towards long-acting injectables like Cabenuva provides an alternative that can enhance treatment satisfaction and contribute to broader public health goals by improving viral suppression rates and reducing the risk of HIV transmission. Further research is ongoing to solidify these benefits across diverse patient groups.