The Center for Disease Control and Prevention (CDC), reports that over forty percent of new HIV infections, and people living with HIV in the United States identify as African American. HIV (Human Immunodeficiency Virus), is a virus that attacks the immune system.
On January 21, 2021, the United States Food and Drug Administration (FDA) approved the injectable drug, Cabenuva, for people living with HIV.
Eligibility: Currently, HIV treatment management consists of routinely taking daily pills. With Cabenuva, individuals living with HIV can take the injectable drug once a month after the one-month oral completion of the drugs, Vocabria and Edurant. Adults who display less than 200 copies of HIV per milliliter of blood are eligible for Cabenuva.
Adults must also display no resistance to either cabotegravir or rilpivirine and a consistent antiretroviral regimen.
How it Works: The same day the last pills of Vocabria and Edurant are taken, an individual will receive the first injections of Cabenuva, which contains cabotegravir and rilpivirine, and is injected at two separate sites on the gluteus. Follow-up injections will be administered a month after the first injections. The dosage of cabetegravir will decrease from an initial 600 mg to 400 mg. Likewise, the dosage of rilpivirine will from 900 mg to 600 mg.
If for any reason an individual misses an injection, they must consult with their clinician. Depending on how many days are missed, they will likely have to resume oral intake of Vocabria and Edurant or take initial injection dosages of cabotegravir and rilpivirine.
Cost and Accessibility: According to WellRx.com, in Maryland, the District of Columbia and Virginia, one dose of Cabenuva will be available for sale at local and chain pharmacies for an estimated amount of $4,000. Currently, a generic form of Cabenuva is not available, which could significantly reduce the cost of the medication.
Dr. Robert Delapenha is a physician who specializes in infectious diseases and HIV/AIDS medicine. He works at a community-based public health organization “Heart to Hand” in Largo, Maryland, to provide services to people living with HIV/AIDS and other sexually transmitted infections.
When asked about his thoughts on Cabenuva, Dr. Delapenha said, “[Cabenuva] should be an important advance in treatment options for patients, as it will allow patients who have difficulty with compliance with medications by mouth to take an injection on a monthly or longer basis.”
For Dr. Delapenha, some of his patients are already asking for the drug. However, the company marketing the drug has not made it available to all HIV providers. He notes that access and cost will probably make up some of the social and health impacts of Cabenuva.
The impact Cabenuva will have on African Americans living with HIV is hard to say at this point in time, according to Dr. Delapenha who estimates that less than 30 percent of individuals will end up getting the drug. However, Dr. Delapenha said that, “[Cabenuva] may be most beneficial to those who have difficulty complying with oral medications.”
Due to homelessness or other living situations where the storage of medication is difficult.
For more information about the drug Cabenuva and the treatment, visit: https://www.fda.gov/drugs/human-immunodeficiency-virus-hiv/fda-approves-cabenuva-and-vocabria-treatment-hiv-1-infection.