Infectious Diseases and Clinical Medicine · africa
One Injection Every Two Months Outperforms Daily Pills: Fewer Viral Rebounds at 96 Weeks in African Adolescent HIV Trial
The LATA trial showed that among adolescents who had achieved viral suppression, switching to long-acting cabotegravir and rilpivirine reduced the confirmed viral rebound rate from 6.4% to 0.9%; the findings directly address the hardest barrier in daily medication—sustained treatment adherence.
For adolescents who must receive lifelong antiretroviral therapy, effective medication is only the starting point; taking it on time every day while navigating school, family life, and social pressures is often the real challenge in maintaining viral suppression. A trial conducted in four African countries showed that replacing daily tablets with injections given once every two months may significantly reduce the risk of the virus becoming active again.
The LATA trial enrolled 476 people with HIV aged 12 to 19 who had achieved viral suppression after treatment, at study sites in Kenya, South Africa, Uganda, and Zimbabwe. Participants either received combined injections of long-acting cabotegravir and rilpivirine or continued taking oral dolutegravir, tenofovir disoproxil fumarate, and lamivudine daily; the 96-week results were presented at the 2026 International AIDS Conference.
According to data released by ViiV Healthcare, 2 of 235 people in the injection group experienced confirmed viral rebound, a rate of 0.9%, compared with 15 of 241 people in the daily oral treatment group, a rate of 6.4%—a difference of 5.5 percentage points. On this basis, the study determined that the long-acting injectable regimen was superior to daily oral treatment in the primary comparison, rather than merely achieving comparable efficacy.
The difference may not necessarily stem from the drugs themselves being more potent; it may also reflect how the method of administration changed the conditions for treatment adherence. Daily medication can easily be disrupted by forgetfulness, privacy concerns, or changes in daily life, while regular injections concentrate medication-taking into a healthcare visit once every eight weeks. Among the 228 participants in the injection group who completed the relevant questionnaire, 215, or 94%, considered injections much easier than taking daily medication.
However, the long-acting regimen did not eliminate adherence issues; instead, it shifted them to attending follow-up visits on time, drug supply, and injection services. These participants had already achieved viral suppression upon entering the study, and the relevant product information also limits eligible patients to those who are at least 12 years old, weigh at least 35 kilograms, have no history of treatment failure, and have no confirmed or suspected resistance to either component; the results cannot be directly extrapolated to adolescents whose virus is not yet controlled or who already have drug resistance.
Currently available information comes primarily from a company press release and conference presentation and is not yet sufficient to fully assess the details of how viral rebound was determined, changes in drug resistance, injection-site reactions, treatment discontinuations, or regional differences. If the effect is maintained after the full study undergoes peer review, LATA will provide rare and direct evidence that, in adolescent HIV treatment, reducing dosing frequency is not merely a convenience but may also translate into more stable viral control.