Long-acting antiretroviral therapy effectiveness and patient satisfaction using patient questionnaires: data from a real-world setting

Background Antiretroviral therapy (ART) for HIV infection has evolved substantially. The development of long-acting drugs, such as cabotegravir (CAB) and rilpivirine (RPV) might improve treatment satisfaction among people living with HIV (PLWH). The real-world effectiveness of long-acting ART and its effect on patient satisfaction needs to be assessed. This study investigated antiviral effectiveness and treatment satisfaction in PLWH who switched from conventional to long-acting ART (CAB + RPV). Methods This prospective cohort study included PLWH aged 18 years and older who switched to CAB + RPV between June 2022 and May 2023. The eligibility criteria included viral suppression, absence of hepatitis B virus (HBV) DNA, and no prior RPV resistance mutations. Clinical data, including renal, lipid, and glucose biomarker levels, were monitored from the baseline to 48 weeks after switching. Treatment satisfaction was assessed using the HIV Treatment Satisfaction Questionnaire. A linear mixed-effects model was employed to estimate changes in clinical data from baseline. Results Thirty-eight male participants were enrolled. Viral suppression was maintained and no cases of virological failure were observed (estimated value:-10.9, 95%CI: -37.5–15.8]. Renal function improved (estimated value: -0.04, 95%CI: -0.07 – -0.01), lipid and glucose profiles remained stable, and treatment satisfaction increased significantly after switching to CAB + RPV(estimated value: 6.6, 95%CI: 2.2–11.0). Conclusion Long-acting ART provides effective viral suppression and enhances treatment satisfaction in PLWH switching from conventional ART. Long-acting ART can improve patient well-being, but patient selection and monitoring to prevent HBV-related complications are important. Ethics and dissemination: This study was conducted as a single-center study and was reviewed and approved by the Ethics Review Committee of Osaka City General Hospital (approval number: 2210072).