| Advantages |
Disadvantages |
Improved adherence
•Decrease in pill intake exhaustion
•Improved consistency in drug intake
•Decrease in virologic failure
|
Pain, erythema, nodule formation at site injection |
| Reduced hepatic, GI and renal toxicity from first pass metabolism |
Need for competent injection technique and for trained health care workers |
| Early detection of non-adherence with lower rates of virologic failure |
Long periods of low drug concentration if injection is missed, likely leading to high risk of resistance |
| Reduced uncertainty about adherence to cART |
Longer time to maximum concentration (can be dealt with oral lead in period) |
| Improved bioavailability |
Potential for development of resistance when doses are missed |
| Decreased overall drug exposure |
Difficulty with withdrawal of drug in the event of toxicity |
| Lower dose API are typically more suitable for , which could lead to potentially reduced costs of ARVs in resource limited settings |
Need for increased clinic visits with monthly injections versus quarterly visits for stable ART patients on oral medications |
| Increased patient confidentiality in situations where stigma or discrimination might exist |
Improved cost with lesser need for active ingredient |
| Can be considered for PreP use |
Use as a PreP option could potentially lead to resistance given subtherapeutic levels if HIV is acquired |
| Nanoemulsions can be injected with reduced volume |
Manufacturing of antibodies can be costly |
| Possibility for painful subcutaneous or subdermal implantation |
Missing a dose may lead to longer coverage-free periods compared to oral doses |
| Much shorter tail of drug exposure in cases where loss-to-follow-up occurs |
|
