{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:04:08Z","timestamp":1784181848339,"version":"3.55.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"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":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Long-acting injectable cabotegravir\/rilpivirine (CAB\/RPV LA) represents a novel antiretroviral strategy that bypasses gastrointestinal absorption, potentially advantageous in pregnant individuals unable to tolerate oral therapy. However, its use in pregnancy remains off-label due to limited pharmacokinetic (PK), safety and clinical outcome data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a 26-year-old woman from Ghana living with HIV-1 (subtype CRF02_AG), with a longstanding history of social vulnerability, poor adherence and multiple treatment interruptions. She presented at gestational week (GW) 20 with an ongoing oral regimen of bictegravir\/emtricitabine\/tenofovir alafenamide (BIC\/FTC\/TAF), initiated weeks earlier. Despite an initial viral load decline, virological rebound to 57,950 copies\/mL was documented at GW 28, attributed to severe hyperemesis gravidarum (HEG) impairing drug intake and absorption. No resistance-associated mutations were detected. Given the inability to tolerate oral therapy, CAB\/RPV LA (600\/900\u00a0mg) was initiated intramuscularly at GW 29, with a second injection 4\u00a0weeks later. Virological suppression (&lt;20 copies\/mL) was achieved within 4\u00a0weeks of the first injection. At GW 36, an elective caesarean section was performed with intravenous zidovudine prophylaxis and neonatal zidovudine syrup, resulting in the delivery of a neonate who has tested HIV-negative on all assessments to date. No adverse maternal or neonatal outcomes were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights HEG as an underrecognised cause of antiretroviral treatment failure mediated by impaired absorption rather than virological resistance, and supports CAB\/RPV LA as a viable rescue strategy in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It also underscores the urgent need for prospective pharmacokinetic and safety data in pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624261461198","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T10:30:52Z","timestamp":1781692252000},"page":"1055-1058","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-acting injectable cabotegravir\/rilpivirine in a pregnant woman living with HIV with hyperemesis gravidarum:a case report and review of literature"],"prefix":"10.1177","volume":"37","author":[{"given":"Emanuela","family":"Lattuada","sequence":"first","affiliation":[{"name":"Azienda Sanitaria Universitaria Integrata Trentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Delama","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Universitaria Integrata Trentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Castelli","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Universitaria Integrata Trentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Mori","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Universitaria Integrata Trentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Piacentini","sequence":"additional","affiliation":[{"name":"San Martino Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4674-4772","authenticated-orcid":false,"given":"Massimiliano","family":"Lanzafame","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Universitaria Integrata Trentina"},{"name":"University of Trento"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2508228"},{"key":"e_1_3_4_3_2","volume-title":"Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States","author":"Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission","year":"2026","unstructured":"Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States. Department of Health and Human Services, 2026. https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/perinatal accessed 15 April 2026."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13439"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae242"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/bcp.70424"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf649"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf604"},{"key":"e_1_3_4_9_2","first-page":"747","article-title":"Physiologically-based pharmacokinetic modelling of long-acting injectable cabotegravir and rilpivirine in pregnancy","volume":"80","author":"Atoyebi S","year":"2024","unstructured":"Atoyebi S, Bunglawala F, Cottura N, et al. Physiologically-based pharmacokinetic modelling of long-acting injectable cabotegravir and rilpivirine in pregnancy. Br J Clin Pharmacol 2024; 80: 747\u2013762.","journal-title":"Br J Clin Pharmacol"},{"key":"e_1_3_4_10_2","first-page":"6207502","article-title":"Long-acting cabotegravir\/rilpivirine for HIV antiretroviral therapy throughout pregnancy: a case report and literature review","volume":"2025","author":"Boudova S","year":"2025","unstructured":"Boudova S, Dutra K, Robbins CL, et al. Long-acting cabotegravir\/rilpivirine for HIV antiretroviral therapy throughout pregnancy: a case report and literature review. Case Rep Infect Dis 2025; 2025: 6207502. https:\/\/doi.org\/10.1155\/crdi\/6207502","journal-title":"Case Rep Infect Dis"},{"key":"e_1_3_4_11_2","unstructured":"IMPAACT Network. IMPAACT 2040: phase I\/II study of the pharmacokinetics and safety of long-acting injectable cabotegravir and rilpivirine in pregnant and postpartum women with HIV-1 (CREATE). https:\/\/www.impaactnetwork.org\/studies\/impaact2040 accessed April 2026."}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261461198","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624261461198","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624261461198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:08:59Z","timestamp":1784178539000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624261461198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":10,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/09564624261461198"],"URL":"https:\/\/doi.org\/10.1177\/09564624261461198","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]}}}