Cabenuva

Cabenuva (Cabotegravir + Rilpivirine) is a long-acting injectable antiretroviral therapy approved for the treatment of HIV-1 infection in adults who are virologically suppressed on a stable antiretroviral regimen with no history of treatment failure or resistance to either component. It is the first complete once-monthly or every-two-months injectable regimen, offering an effective alternative to daily oral HIV therapy and helping improve long-term adherence and treatment convenience.
Cabenuva combines two antiretroviral agents with complementary mechanisms of action. Cabotegravir is an integrase strand transfer inhibitor (INSTI) that prevents the integration of viral DNA into the host cell genome, a critical step in HIV replication. Rilpivirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that blocks reverse transcriptase activity, preventing viral RNA from being converted into DNA. Together, these agents provide potent and durable viral suppression when administered as scheduled injections.
The regimen is administered as two separate intramuscular injections into the gluteal muscles by a healthcare professional. Many patients begin treatment with an oral lead-in phase to confirm tolerability, although direct initiation with injections may be appropriate in selected individuals. Common adverse effects include injection-site reactions, headache, fatigue, fever, nausea, and musculoskeletal pain. Injection-site reactions are usually mild to moderate and typically resolve within a few days.
Cabenuva represents a major advancement in HIV treatment and long-term disease management. By reducing pill burden and eliminating daily dosing, it decreases treatment fatigue and minimizes daily reminders of HIV status. Its long-acting formulation supports sustained viral suppression, enhances quality of life, and reflects a shift toward more flexible, patient-centered approaches in modern HIV care.