{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:58:14Z","timestamp":1792979894505,"version":"4.5.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>This case report describes the first documented use of lenacapavir in the setting of Y188L NNRTI resistance mutation during pregnancy, resulting in successful maternal viral suppression and prevention of vertical transmission of HIV. A 24-year-old woman with prior poor adherence, socioeconomic instability, and NNRTI resistance (Y188\u00a0L mutation) presented with uncontrolled viremia during her second pregnancy. After consultation with perinatal HIV experts, she initiated a long-acting injectable regimen combining lenacapavir (927\u00a0mg subcutaneous every 6\u00a0months) and cabotegravir\/rilpivirine (600\/900\u00a0mg intramuscular every 2\u00a0months). Rapid viral load reduction was achieved, declining from 147,351 to 67 copies\/mL within weeks. Despite transient hepatotoxicity, the patient delivered an HIV-negative infant at term. Maternal HIV RNA remained &lt;50 copies\/mL postpartum and became undetectable by January 2025. The infant remained HIV-negative at 18-months follow-up. This case demonstrates the potential role of long-acting antiretroviral therapy (ART) in achieving sustained virologic control among pregnant patients with adherence challenges and drug resistance. While lenacapavir shows promise as a biannual agent addressing barriers to adherence, its pharmacokinetics and safety during pregnancy remain uncharacterized. These findings underscore the urgent need for systematic studies and pregnancy registries evaluating long-acting ART agents in maternal populations to optimize outcomes and eliminate vertical transmission in hard-to-treat cases.<\/jats:p>","DOI":"10.1177\/09564624261415720","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:10:06Z","timestamp":1768608606000},"page":"671-673","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Successful Use of lenacapavir and cabotegravir\/rilpivirine for virologic suppression in pregnancy: A Case Report"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4511-3546","authenticated-orcid":false,"given":"Mahima","family":"Upadhyay","sequence":"first","affiliation":[{"name":"Hurley Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susheel","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urooj","family":"Khan","sequence":"additional","affiliation":[{"name":"Hurley Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Irani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Liroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"Global HIV & AIDS statistics\u2014fact sheet","author":"UNAIDS","year":"2023","unstructured":"UNAIDS. Global HIV & AIDS statistics\u2014fact sheet, 2023. https:\/\/www.unaids.org\/en\/resources\/fact-sheet"},{"key":"e_1_3_3_3_2","article-title":"Recommendations for the use of antiretroviral drugs during pregnancy","author":"Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission","year":"2023","unstructured":"Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. Recommendations for the use of antiretroviral drugs during pregnancy. ClinicalInfo.HIV.gov 2023. https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/perinatal","journal-title":"ClinicalInfo.HIV.gov"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1904398"},{"issue":"18","key":"e_1_3_3_5_2","first-page":"1793","article-title":"Long-acting lenacapavir in people with multidrug-resistant HIV-1 infection","volume":"386","author":"Orkin C","year":"2022","unstructured":"Orkin C, DeJesus E, et al. Long-acting lenacapavir in people with multidrug-resistant HIV-1 infection. N Engl J Med 2022; 386(18): 1793\u20131803.","journal-title":"N Engl J Med"},{"key":"e_1_3_3_6_2","unstructured":"A case of lenacapavir use for preventing mother-to-child HIV transmission - PubMed."},{"key":"e_1_3_3_7_2","volume-title":"Outcomes of lenacapavir administration during pregnancy","author":"Mofenson L","year":"2025","unstructured":"Mofenson L, Ingold H, et al. Outcomes of lenacapavir administration during pregnancy. NCBI Bookshelf, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK616667\/"},{"key":"e_1_3_3_8_2","unstructured":"Fonner V Charles KL et al. Safety and efficacy of long-acting injectable lenacapavir as pre-exposure prophylaxis to reduce the risk of HIV acquisition. A Systematic Review."},{"key":"e_1_3_3_9_2","volume-title":"NCBI Bookshelf","year":"2025","unstructured":"NCBI Bookshelf, 2025. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK616670\/"},{"key":"e_1_3_3_10_2","volume-title":"Presented at: Conference on Retroviruses and Opportunistic Infections (CROI)","author":"Patel P","year":"2023","unstructured":"Patel P, Cressey T, Thiagarajah S, et al. Pharmacokinetics of cabotegravir during pregnancy: preliminary findings from IMPAACT 2032. Presented at: Conference on Retroviruses and Opportunistic Infections (CROI). Conference on Retroviruses and Opportunistic Infections, 2023. https:\/\/www.croiconference.org, In this issue."},{"key":"e_1_3_3_11_2","unstructured":"https:\/\/www.apregistry.com\/"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261415720","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624261415720","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261415720","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:47:31Z","timestamp":1777675651000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624261415720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/09564624261415720"],"URL":"https:\/\/doi.org\/10.1177\/09564624261415720","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]}}}