{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:07:56Z","timestamp":1771326476149,"version":"3.50.1"},"reference-count":3,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,1,6]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>This case describes successful management of a man with perinatally acquired HIV complicated by incomplete adherence, multidrug-resistant HIV and opportunistic infections\u2014cryptococcal meningitis and mycobacterium avium intracellulare. Initial treatment included antifungal and antimycobacterials with oral antiretroviral therapy (ART), but persistent high HIV viral load (&gt;100\u2009000 copies\/mL) prompted initiation of long-acting injectable ART (LAI-ART) with cabotegravir and rilpivirine combined with adjunct oral nucleoside reverse transcriptase inhibitor therapy (emtricitabine\/tenofovir). This combination is expected to have reduced antiviral activity secondary to resistant mutations; notably, high-level resistance to emtricitabine and intermediate resistance to rilpivirine. To attenuate further resistance, 4-weekly dosing of LAI-ART was used. This regimen led to viral suppression within 4\u2009weeks, which remains suppressed (&gt;1 year) and successful immune reconstitution (CD4 cell count of 209\u2009cells\/\u00b5L\/18.7%), despite challenges with adherence to oral medications. This case highlights the feasibility and effectiveness of LAI-ART in managing complex resistance and adherence in perinatally acquired HIV.<\/jats:p>","DOI":"10.1136\/sextrans-2025-056679","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T18:20:55Z","timestamp":1768587655000},"page":"107-108","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Role of long-acting injectables in perinatally acquired HIV, with persistent viraemia and non-nucleoside reverse transcriptase inhibitor resistance"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7635-0947","authenticated-orcid":false,"given":"Ali","family":"Grant","sequence":"first","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Keegan","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjababu","family":"Kulasegaram","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"2026021702100699000_102.2.107.1","first-page":"478","article-title":"Incidence and predictors of antiretroviral resistance in perinatally HIV-1 infected children and adolescents","volume":"70","author":"German","year":"2015","journal-title":"J Infect"},{"key":"2026021702100699000_102.2.107.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-012-0364-1"},{"key":"2026021702100699000_102.2.107.3","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad390","article-title":"Projected Benefits of Long-Acting Antiretroviral Therapy in Nonsuppressed People With Human Immunodeficiency Virus Experiencing Adherence Barriers","volume":"10","author":"Chen","year":"2023","journal-title":"Open Forum Infect Dis"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056679","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:10:23Z","timestamp":1771323023000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056679"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":3,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,17]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/sextrans-2025-056679"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056679","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}