Around 13,000 adults living with HIV in England will be eligible for the injection via the NHS, which has been hailed as “incredible news” by charities who said it would help make treatment easier.
Many people living with HIV can keep the virus at very low levels by taking between one and four antiretroviral tablets each day, allowing a near-normal life span.
These drugs keep the number of virus particles in the blood – also known as the viral load – so low that it cannot be detected or transmitted between people.
But the approval of the injection means many living with HIV in England will no longer need daily treatment and can have two injections every two months.
This means they can reduce the days they receive treatment from 365 to six per year and the injectable minimises the risk of missing doses essential for virus control.
The National Institute for Health and Care Excellence (Nice) said the two injections - cabotegravir - also called vocabria, made by Viiv Healthcare - with rilpivirine - also called Rekambys, made by Janssen - can be offered to adults who have managed to keep HIV viral load to a low level through daily antiretroviral medicines.
Clinical trial results show that cabotegravir with rilpivirine is as effective as oral antiretrovirals at maintaining a low viral load, Nice said.
Meindert Boysen, deputy chief executive Nice, said although HIV can be controlled by modern treatment, "for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle."
She said the combination of cabotegravir with rilpivirine is a valuable option for people who "already have good levels of adherence to daily tablets, but who might prefer an injectable regimen with less frequent dosing.”
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Debbie Laycock, head of policy at charity the Terrence Higgins Trust, said: “HIV unfortunately remains a stigmatised condition.
"Although we’re working hard to tackle the stigma surrounding HIV, this new injectable treatment option could help people in house-shares for example who do not wish to share their HIV status and will no longer have to worry about hiding their medication."
She said pill fatigue can also be an issue for some people who struggle taking tablets every day and those who have difficulty swallowing medication.
Ms Laycock hailed it as "incredible news", adding: ‘This is a great step forward as we work towards ending new cases of HIV by 2030. The institute’s decision brings great potential for HIV prevention including long-lasting PrEP in the future.”
Deborah Gold, chief executive of National Aids Trust, said the charity was “delighted” with the news, adding: “The voice of people living with HIV is clear: they want this technology available as part of a range of treatment options.
"It won’t be right for everyone but, for some, monthly injections are highly preferable to daily pills.
“Innovations that can make it easier for people to stick to their treatment plans both improve the wellbeing of people living with HIV".