Use of Long-acting Injectable Antiretroviral Therapy in Kidney and Liver Transplant Recipients with HIV

Background: The 2013 HIV Organ Policy Equity Act facilitated HIV-to-HIV organ transplants, enabling people with HIV to receive transplants more quickly. However, managing drug interactions between ART and immunosuppressive regimens remains a challenge. Objective: This study assesses the safety and effectiveness of cabotegravir/rilpivirine (CAB/RPV), an injectable ART, in maintaining HIV virologic suppression in kidney and liver transplant recipients. Methods: A retrospective review of three clinical studies evaluated CAB/RPV in transplant recipients with HIV. Participants had suppressed HIV RNA levels before transplant and were monitored post-transplant every six months. Results: Nine transplant recipients (7 kidney, 2 liver) received CAB/RPV. All maintained HIV suppression, with no allograft loss, although one liver recipient experienced acute rejection. One participant died from trauma unrelated to the transplant or HIV. Conclusion: CAB/RPV shows promise for HIV management after transplantation. Further research is needed using a larger cohort.