Long-acting Cabenuva beats daily oral HIV therapy in adolescents | AIDS 2026

Long-acting Cabenuva (cabotegravir and rilpivirine) dosed every eight weeks was superior to a daily oral combination of dolutegravir/tenofovir disoproxil fumarate/lamivudine in adolescents living with HIV in Kenya, South Africa, Uganda and Zimbabwe, according to data presented at the International AIDS Conference (AIDS 2026) being held this week in Rio de Janeiro, Brazil.

“Adolescents living with HIV have poor treatment outcomes compared to adults, and long-acting injectables using cabotegravir and rilpivirine has demonstrated non-inferior efficacy and safety, as well as high acceptability in trials involving virologically suppressed adults across diverse populations. But the only previous trial of LAI [long-acting injectables] in adolescents was a single-arm trial," said Mutsawashe F. Bwakura, associate professor in the department of pediatrics and child health at the University of Zimbabwe.

HIV is the virus that causes AIDS. Approximately 40.8 million people worldwide are currently living with HIV; about 1.2 million people in the United States are living with HIV. About 1.3 million people worldwide are diagnosed each year.

Marketed by ViiV Healthcare, Cabenuva is a long-acting injectable therapy for patients 12 years and older with HIV to maintain virus suppression. It is approved by the FDA to be given as an intramuscular injection and can be given monthly or every two months.

The LATA trial is the first randomized trial to compare long-acting Cabenuva to anti-retroviral therapy in adolescents. LATA was an open-label study that enrolled 476 virologically suppressed adolescents aged 12 to 19 years; 235 patients were randomized to the Cabenuva arm, and 241 patients were in the anti-retroviral arm. Patients were followed for 96 weeks. The primary endpoint was viral rebound anytime during the trial period.

Researchers found that two patients in the Cabenuva arm compared with 15 in the control arm confirmed viral rebound. One of the patients in the Cabenuva arm switched to an alternate therapy and achieved viral suppression, Bwakura said during the presentation. The second patient had received the long-acting injectable at four weeks but stopped due to an adverse event.

The trial found that Cabenuva was well tolerated with no new safety concerns. Bwakura said injection site reactions were mainly mild and pain-related, and none of them led to discontinuation of the long-acting therapy.

The long-acting injection was preferred among adolescents; 94% of those who received the long-acting injectable reported that it was much easier to take than daily oral therapy. “Nearly 100% of all participants reported that taking HIV medicines was not a burden and it didn't interfere with their normal life,” Bwakura said. “However, when those who were in the LAI arm were asked, they found said that it was a lot easier.”

The World Health Organization guidelines, she pointed out, recommend long-acting injectables as an alternative for virally suppressed adolescents as a way to reduce the burden of daily oral therapies. “But access to LAI remains limited in regions where the need is greatest.”

WHO’s guidelines were updated in December 2025. Changes to the guideline include the introduction of new antiretroviral drugs and regimens and revised postnatal prophylaxis and breastfeeding guidelines for managing infants at risk of vertical transmission.