NICE has published draft guidance recommending the first long-acting injectable treatment for HIV-1 infection in adults, offering an alternative to adults living with HIV who have to take daily antiretroviral drugs. This marks the first time NICE has made recommendations about the use of an HIV treatment since these came under NICE’s remit in 2019.

Cabotegravir (also known as Vocabria), made by ViiV Healthcare, with rilpivrine (also called Rekambys), made by Janssen, has been shown in clinical trials to be as effective as oral antiretrovirals at keeping the viral load low. Both are administered as 2 separate injections, every two months, after an initial oral tablet lead-in period. This reduces treatment from 365 to six per year.

The treatment is recommended as an option for adults with HIV-1 infection when antiretroviral medicines have kept the virus at a low level, and where there is no evidence to suspect viral resistance. It is estimated that around 13,000 people in England will now be eligible for treatment with cabotegravir with rilpivirine.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Assessment at NICE said: “Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment. However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle.”

The announcement follows a positive decision from the SMC in October 2021, enabling those living with HIV in Scotland access to the long-acting injectable regimen within NHS Scotland.

Dr Nneka Nwokolo at ViiV Healthcare shared: “We understand that no medicine works for every individual living with HIV, so we are committed to offering innovative choices that help address their evolving needs. We are delighted that NICE has approved the first and only complete long-acting injectable HIV medicine, allowing us to focus on the people living with the condition and provide them with treatment options that remove the need for regular daily HIV tablets.”