A Study Evaluating the Pharmacokinetics, Efficacy, Safety and Tolerability of CABENUVA

Exclusion Criteria

• •1. Screening plasma HIV-1 RNA measurement \> 50 c/mL
• •2. Within 6 months prior to Screening, any plasma HIV-1 RNA measurement \> 200 c/mL
• •3. Women who are pregnant, breastfeeding or plan to become pregnant or breastfeed during the study
• •4. Participants with severe hepatic impairment (Class C) as determined by Child-Pugh classification
• •5. Any pre-existing physical or mental condition (including substance use disorder) which, in the opinion of the Investigator, may interfere with the participant's ability to comply with the dosing schedule and/or protocol evaluations or which may compromise the safety of the participant
• •6. Participants who, in the investigator's judgment, pose a significant suicide risk as assessed via the Columbia Suicidality Severity Rating Scale (C-SSRS). In addition, participant's recent history of mental health, psychiatric history, suicidal behavior and/or suicidal ideation should be considered when evaluating for suicide risk.
• •7. Evidence of active Hepatitis B virus (HBV) infection based on the results of testing at Screening for Hepatitis B surface antigen (HBsAg), Hepatitis B core antibody (anti-HBc), Hepatitis B surface antibody (anti-HBs) and HBV DNA as follows:
• •* Participants positive for HBsAg are excluded:
• •* Participants negative for anti-HBs but positive for anti-HBc (negative HBsAg status) and positive for HBV DNA are excluded, not excluded if HBV DNA is negative or not detected
• •* Participants positive for anti-HBc (negative HBsAg status) and positive for anti-HBs (past and/or current evidence) are immune to HBV and are not excluded
• •8. Asymptomatic individuals with chronic hepatitis C virus (HCV) infection will not be excluded, however Investigators must carefully assess if therapy specific for HCV infection is required; participants who are anticipated to require HCV treatment within 12 months must be excluded.
• •9. Participants with HCV co-infection will be allowed entry into this study if:
• •1. Liver enzymes meet entry criteria
• •2. HCV Disease has undergone appropriate work-up, and is not advanced, and will not require treatment prior to the Week 52 visit. Additional information (where available) on participants with HCV co-infection at screening should include results from any liver biopsy, fibroscan, ultrasound, or other fibrosis evaluation, history of cirrhosis or other decompensated liver disease, prior treatment, and timing/plan for HCV treatment.
• •3. In the event that recent biopsy or imaging data is not available or inconclusive, the Fib-4 score will be used to verify eligibility
• •4. Fib-4 score \>3.25 is exclusionary
• •5. Fib-4 scores 1.45 - 3.25 will require review by site PI to ensure that participant does not have severe liver disease and severe renal dysfunction. Fibrosis 4 Score Formula: (Age x AST) / (Platelets x (sqr \[ALT\])
• •10. History of liver cirrhosis with or without hepatitis viral co-infection
• •11. Ongoing or clinically relevant pancreatitis
• •12. Any condition which, in the opinion of the Investigator, may interfere with the absorption, distribution, metabolism or excretion of the study drugs or render the participant unable to receive study medications
• •13. History or presence of allergy or intolerance to the study drugs or their components or drugs of their class. In addition, if heparin is used during PK sampling, participants with a history of sensitivity to heparin or heparin-induced thrombocytopenia must not be enrolled
• •14. Current or anticipated need for chronic anti-coagulation or hereditary coagulation and platelet disorders such as hemophilia or Von Willebrand Disease. The exception are the use of low dose acetylsalicylic acid (≤325 mg) or if, clinically, is safe to hold the anticoagulant for 1-3 days prior to the target time of CABENUVA injections and to re-start it 12 hours after the IM injections (upon Pharmacist, cardiologist or hematologist opinion).
• •15. Any evidence of primary resistance based on the presence of any major known INI or NNRTI resistance-associated mutation, except for K103N, (IAS, 2015) by any historical resistance test result. Note: Prior genotypic resistance testing is not required but if available it must be documented to provide direct evidence of no preexisting exclusionary resistance mutations. Details regarding baseline or prior resistance data must be noted in the source documentation
• •16. Any verified Grade 4 laboratory abnormality except Creatinine level (See Appendix 11). A single repeat test is allowed during the Screening phase to verify a result
• •17. Any acute laboratory abnormality at Screening, which, in the opinion of the investigator, would preclude the participant's participation in the study of an investigational compound
• •18. Alanine aminotransferase (ALT) \>=5x ULN, OR ALT \>=3xULN and bilirubin \>=1.5xULN (with \>35% direct bilirubin)
• •19. Exposure to an experimental drug or experimental vaccine within either 30 days, 5 half-lives of the test agent, or twice the duration of the biological effect of the test agent, whichever is longer, prior to Day 1 of this study: Treatment with any of the following agents within 28 days of Screening:
• •1. radiation therapy
• •2. cytotoxic chemotherapeutic agents
• •3. tuberculosis therapy with the exception of isoniazid (isonicotinylhydrazid, INH)
• •4. Immunomodulators that alter immune responses such as chronic systemic corticosteroids, interleukins, or interferons. (Note: Participants using short-term (e.g., ≤21 days) systemic corticosteroid treatment; topical, inhaled, and intranasal corticosteroids are eligible for enrolment)
• •20. Treatment with an HIV-1 immunotherapeutic vaccine within 90 days of Screening
• •21. Use of medications which are associated with Torsade de Pointes.
• •22. Participants receiving any prohibited medication and who are unwilling or unable to switch to an alternate medication.
• •23. Unstable renal disease and/or anticipated need for renal transplant within 1 year of study entry.
• •Note: Any prohibited medications that decrease CAB or RPV concentrations should be discontinued for a minimum of four weeks or a minimum of three half-lives (whichever is longer) prior to the first dose and any other prohibited medications should be discontinued for a minimum of two weeks or a minimum of three half-lives (whichever is longer) prior to the first dose.