HIV Study: Injection versus Pill

February 01, 2018

When John Henry spent three weeks cycling across Great Britain last summer, he didn't need to take along a three-week supply of antiretroviral pills for HIV. As part of a study at The Ottawa Hospital, Henry receives an injection once every eight weeks instead.

When John Henry spent three weeks cycling across Great Britain last summer, he didn't need to take along a three-week supply of antiretroviral pills for HIV. Instead, Henry receives an injection once every eight weeks.

"Replacing daily pills with something that is injected and slowly released into the body – it amazes me that it's possible, but it works," said Henry. "You're free from pills, which is great if you go on vacation. And between the eight weeks, you actually forget that you have it."

For Henry, taking a pill is a daily reminder that he has the human immunodeficiency virus (HIV), which breaks down the immune system until the person can't fight off infections or diseases. Two decades ago, a diagnosis of HIV was a death sentence. While there is still no cure, taking one pill a day can suppress the virus.

HIV study 1.jpg

​Henry is part of an international study, co-authored by Dr. Jonathan Angel, that showed how an injection of the long-lasting forms of antiretroviral drugs every four or eight weeks could suppress viral growth just as well as a daily pill. The trial involved nearly 300 patients across 50 sites in five countries. In Canada, only The Ottawa Hospital and one site in Montreal took part in the clinical trial. The trial targeted people who had not taken any antiretroviral medication. Henry fit this criteria, since he had been recently diagnosed when the trial opened in June 2014.

(Dr. Jonathan Angel (left), Head of Infectious Diseases at The Ottawa Hospital and Associate Professor of Medicine at the University of Ottawa, led a study to find if an injection was as effective as a pill for controlling HIV.)

"I got a firm diagnosis, two months before taking treatment," said Chad Raymond, who began taking part in the trial in October 2014. "The idea of doing injections appealed to me because of the infrequency of it. I was happy to get away from doing something on a daily basis, as I worried about missing a dose. So an injection once every month was more appealing."

"Years ago, a person had to take a handful of pills two to three times a day, and there were lots of side effects," said Nancy Tremblay, Clinical Research Coordinator for the trial. "We've progressed from that to one pill, once a day. It's very effective with very few side effects, if any. And now injectables offer another option."

Patients receive two separate intramuscular injections of the antiretroviral drugs cabotegravir and rilpivirine, which are released slowly and last a full month or two months, depending on which schedule they are on.

"The big thing is it provides another option for people who have a physical or psychological aversion to taking pills," said Dr. Angel, Head of Infectious Diseases at The Ottawa Hospital and Associate Professor of Medicine at the University of Ottawa.

The study was funded by ViiV Healthcare and Janssen R&D. Community support for The Ottawa Hospital is also crucial for all research studies, in particular research into HIV and gay men's health.

Recommended Reading