Cabotegravir, as a long-acting HIV integrase inhibitor, is mainly suitable for adult HIV infected individuals, but strict evaluation of contraindications and medication risks for special populations is required. The following provides a detailed explanation from three aspects: applicable population, contraindications, and medication for special populations.

1. Target audience

(1) Adult HIV-1 infected individuals: suitable for patients over 12 years old and weighing ≥ 35kg, and should be used in combination with other antiretroviral drugs.

(2) Pre exposure prophylaxis (PrEP): Suitable for HIV prevention in high-risk populations, but excluding patients in the acute HIV infection phase.

2. Contraindications

(1) Allergy history: Individuals with a history of severe allergic reactions to integrase inhibitors are contraindicated.

(2) Drug interactions: Do not use in combination with potent CYP3A4 inducers such as rifampicin and carbamazepine.

(3) Concomitant infection: it is forbidden for untreated patients with hepatitis B/C infection, because it may cause severe hepatotoxicity.

3. Medication for special populations

(1) Pregnancy period: The safety classification for pregnancy is Class B, and it is necessary to weigh the pros and cons when using it. Animal experiments have shown that high doses can cause embryonic toxicity, but human data is limited.

(2) Breastfeeding period: Medications can be secreted into breast milk, and HIV positive mothers should avoid breastfeeding to prevent virus transmission.

(3) Liver dysfunction: Oral preparations are prohibited for Child Pugh C patients; Patients with mild to moderate liver damage need to reduce their dosage by 50% and closely monitor their ALT levels.

(4) Renal insufficiency: No dosage adjustment is required, but patients with end-stage renal disease should use injectable formulations with caution.

(5) Elderly: Patients over 65 years old need to be evaluated for liver and kidney function, and maintenance doses may need to be reduced.

4. Medication for children

(1) Adolescents aged 12-17: must have a weight of ≥ 35kg and a dosage equivalent to that of adults.

(2) Children under 12 years old: Safety and efficacy have not been established, and use is not recommended.