New Drug Combo Restores HIV Control

A new long-acting drug combo can restore control over HIV for patients whose virus has developed resistance to commonly used medications, researchers report.

HIV patients who have trouble taking daily pills can opt for injections of cabotegravir and rilpivirine (Cabenuva), a long-acting treatment that can be given weeks or months apart.

However, HIV can develop resistance to rilpivirine, limiting its use in some patients, researchers noted.

This can be countered by subbing out another drug for rilpivirine, allowing patients to continue with long-term HIV treatment, researchers reported Oct. 8 in JAMA Network Open.

Swapping lenacapavir in place of rilpivirine maintained long-term control over HIV among a small group of patients being treated at the University of California, San Francisco (UCSF), researchers said.

“Clinicians are already starting to use these two drugs together, and until now we’ve had very little evidence to guide us,” senior researcher Dr. Monica Gandhi, a professor of medicine at UCSF, said in a news release. 

Lenacapavir is a long-acting drug that attacks HIV in a different way than rilpivirine, researchers said. It disrupts the virus’ protective protein shell, blocking multiple steps in its life cycle, according to Drugs.com.

By comparison, rilpivirine belongs to a class of drugs called nucleoside or nucleotide reverse transcriptase inhibitors (NTRIs), which prevent HIV from copying its RNA into DNA to easily replicate itself.

For the new study, researchers recruited 46 patients being treated at UCSF’s Ward 86 HIV Clinic. Of those patients, nearly three-quarters had developed the type of drug resistance that can limit use of the Cabenuva combo, and more than half had detectable HIV.

The new lenacapavir/cabotegravir combo brought HIV under control within 13 weeks among patients with detectable levels, according to the study.

And after nearly two years, all of the patients continued to have undetectable HIV viral loads, researchers said.

“This is the largest group studied on this combination, and we think these findings could help providers have more confidence using it,” Gandhi said.

The study was funded by a federal grant, and was not supported by any pharmaceutical companies, researchers said.

More information

The Mayo Clinic has more on treating HIV.

SOURCE: University of California, San Francisco, news release, Oct. 8, 2026