In a large trial in sub-Saharan Africa, injections given every eight weeks resulted in fewer cases of viral rebound than daily oral HIV medication. Radboudumc researchers contributed to research on the dosing of the injectable treatment.
Long-acting HIV treatment given by injection every eight weeks is more effective than daily oral medication at maintaining viral suppression in adolescents who already have their HIV under control. This is shown by the LATA trial, involving 476 adolescents in Kenya, South Africa, Uganda, and Zimbabwe. The results were published in The Lancet.
Globally, an estimated 1.57 million adolescents aged 10 to 19 were living with HIV in 2024, around 90% of them in sub-Saharan Africa. Adolescents often have poorer treatment outcomes than adults, with daily medication posing particular challenges because of factors such as pill burden, stigma, mental health problems, and increasing independence.
Fewer cases of viral rebound
The LATA trial compared two treatment strategies in adolescents whose HIV was already suppressed. Half switched to long-acting injections of cabotegravir and rilpivirine every eight weeks. The other half continued daily tablets containing dolutegravir, lamivudine, and tenofovir.
After 96 weeks, two of 235 adolescents receiving the injections had confirmed viral rebound, compared with 15 of 241 adolescents taking daily oral treatment. The injectable treatment was first shown to be non-inferior and subsequently proved superior for the primary study outcome.
“Only two adolescents receiving the injections had confirmed viral rebound, compared with 15 on daily oral treatment,” says David Burger from Radboudumc’s Department of Pharmacy, Pharmacology and Toxicology. “That is an encouraging result and shows that long-acting treatment can be a very effective maintenance option for adolescents whose HIV is already well controlled.”
No new safety concerns were identified. Serious adverse events occurred at similar rates in both groups. Injection-site reactions were common, but most were mild and short-lived.
The treatment was also well received by participants. At 96 weeks, 94% of adolescents receiving the injections said they found them much easier than taking daily medication.
Radboudumc contribution
Burger is a co-author of the study. Radboudumc researchers also coordinated a pharmacokinetic substudy investigating how cabotegravir and rilpivirine behave in the body and whether the dosing used in adolescents provides appropriate drug exposure.
This work was coordinated by Lisanne Bevers, Tom Jacobs, and David Burger. The laboratory analysis of cabotegravir and rilpivirine was developed at Radboudumc by Noor van Ewijk-Beneken Kolmer and Lindsey te Brake. Results from this pharmacokinetic substudy will be published separately.
“Our role was to investigate whether the dosing of cabotegravir and rilpivirine provides appropriate drug exposure in adolescents,” Burger explains. “That information is essential if this treatment is to be used safely and effectively in younger patients.”
An alternative to daily medication
Long-acting treatment could offer an important alternative for adolescents who find taking tablets every day difficult. However, the researchers emphasize that the trial included adolescents who already had good viral suppression and were well engaged in HIV care. Further research is therefore needed to determine how well the treatment works for adolescents with persistent adherence problems, treatment failure, or poorer access to care.
The LATA trial was funded by the European and Developing Countries Clinical Trials Partnership (EDCTP2), Janssen Pharmaceutical/Johnson & Johnson, and the UK Medical Research Council.
About the publication
Bwakura-Dangarembizi M, Chappell E, Kityo C, et al. (2026). Switch to injectable cabotegravir–rilpivirine given every 8 weeks in adolescents living with HIV with virological suppression in sub-Saharan Africa (LATA): a randomised, open-label, multicentre, 96-week non-inferiority trial. The Lancet. DOI: 10.1016/S0140-6736(26)01537-0.
