Would you consider using long-acting injectable cabotegravir/rilpivirine for pregnant women with HIV?

At this time, long-acting injectable cabotegravir/rilpivirine (CAB/RPV) is not generally recommended during pregnancy due to limited safety data and unknown effects on the developing fetus. So far, there have not been any reported safety concerns regarding harm to the fetus for either long-acting injectable cabotegravir (which has been studied in PrEP trials) or oral rilpivirine.

There are significant concerns about drug levels, particularly of rilpivirine in the 3rd trimester, but there are very...

Yes! I am part of a consortium for Southeast Michigan that treats pregnant women, and this injectable has been used many times with good outcomes. I think the Patel article (although small) shows low risk. Additional PBPK information was recently presented at CROI: Patel et al., CROI 2020.