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Real members of myHIVteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.
A myHIVteam Member asked a question 💭
New York, NY

Had second round of Cabenuva last week, with blood work. My doctor called me today to let me know that I'm not undetectable, she said there's a blip and I'm like 80 instead of <30. I've been undetectable since I've been on meds, well over 10yrs. Should I continue with the shots or go back to Biktarvy? I thought about giving it another shot (pardon the pun) in two months. Thoughts?

February 24
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myHIVteam

Should you continue with Cabenuva after experiencing a viral load blip?

A blip to 80 copies after your second injection can happen, especially during the transition period. Since you've only had two doses, the medication may still be building up to optimal levels in your system.

Here are some things to consider:

- Cabenu Show Full Answer

Should you continue with Cabenuva after experiencing a viral load blip?

A blip to 80 copies after your second injection can happen, especially during the transition period. Since you've only had two doses, the medication may still be building up to optimal levels in your system.

Here are some things to consider:

- Cabenuva's extended-release formula can take time to reach full effectiveness
- Missing or delaying doses can affect viral suppression, so timing is important
- Your doctor may want to test for drug resistance to cabotegravir or rilpivirine to ensure the medications are working properly
- Some people need a few months to achieve stable viral suppression on injectable therapy

Given your long history of being undetectable, this blip is worth investigating but may not mean the treatment isn't working. Your idea of giving it another two months could be reasonable, but this decision should be made with your doctor.

They may recommend resistance testing to make sure you're not developing resistance to these medications, especially since cabotegravir can stay in your system for up to 12 months.

February 24
A myHIVteam Member

I’m on CAbenuva and hopefully never go back to pills are the worst - seek advice from your doctor

February 25
A myHIVteam Member

Honestly, 80 sounds more like a blip, especially since you just started Cabenuva and it was only your second injection.
Transitions between regimens can sometimes cause a temporary bump. It’s still very low and under 200, which usually isn’t considered treatment failure.
If it were me, I’d probably repeat labs before making a decision to switch back. One result doesn’t necessarily mean the shots aren’t working.
But of course, follow your doctor’s guidance. I hope it goes back to undetectable next test.

February 25

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