Successful initiation of fully parenteral antiretroviral therapy in a treatment-naïve person with HIV-1 infection and intestinal failure - PubMed
6 hours ago
- #HIV-1 treatment
- #intestinal failure
- #parenteral antiretroviral therapy
- A treatment-naïve 26-year-old male with HIV-1 and severe intestinal failure due to complications from necrotizing pancreatitis required fully parenteral antiretroviral therapy (ARV) due to inability to use oral medication.
- An off-label regimen of intravenous zidovudine (AZT) combined with intramuscular long-acting cabotegravir/rilpivirine (CAB/RPV LA) was initiated, leading to viral suppression (HIV RNA <20 copies/mL) within 65 days and CD4+ recovery.
- Intravenous AZT was discontinued after 35 days, with ongoing CAB/RPV LA maintenance during recovery and home parenteral nutrition, demonstrating the regimen's tolerability alongside other treatments.
- This case suggests fully parenteral ARV, including CAB/RPV LA, can be a safe and effective bridge to viral suppression in patients with absolute contraindications to oral therapy, highlighting the need for further evaluation.