Cabotegravir, sold under the brand name Vocabria among others, is a antiretroviral medication used for the treatment of HIV/AIDS. It is available in the form of tablets and as an intramuscular injection, as well as in an injectable combination with rilpivirine under the brand name Cabenuva.It is an integrase inhibitor with a carbamoyl pyridone structure similar to that of dolutegravir.In December 2021, the U.S. Food and Drug Administration approved cabotegravir for pre-exposure prophylaxis (PrEP) in at-risk people under the brand name Apretude. Medical uses
Cabotegravir in combination with rilpivirine is indicated for the treatment of human immunodeficiency virus type-1 (HIV-1) in adults. The combination injection is intended for maintenance treatment of adults who have undetectable HIV levels in the blood (viral load less than 50 copies/mL) with their current antiretroviral treatment, and when the virus has not developed resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) and integrase strand transfer inhibitors. The tablets are used to check whether a person tolerates the treatment before the injection therapy is started.The two medicines are the first antiretroviral drugs that come in a long-acting injectable formulation.Cabotegravir (Apretude) is indicated for use in at-risk people weighing at least 35 kilograms (77 lb) for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV. Contraindications and interactions
Cabotegravir must not be combined with the drugs rifampicin, rifapentine, carbamazepine, oxcarbazepine, phenytoin or phenobarbital, which induce the enzyme UGT1A1. These drugs significantly decrease cabotegravir concentrations in the body and thus may reduce its effectiveness.
A vesicointestinal fistula (or intestinovesical fistula) is a form of fistula between the bladder and the bowel. Types
A fistula involving the bladder can have one of many specific names, describing the specific location of its outlet:

Bladder and intestine: "vesicoenteric", "enterovesical", or "vesicointestinal"
Bladder and colon: "vesicocolic" or "colovesical"
Bladder and rectum: "vesicorectal" or "rectovesical"

Symptoms and signs
If fecal matter passes through the fistula into the bladder, the existence of the fistula may be revealed by pneumaturia, fecaluria, or recurrent urinary tract infection. Migration of urine through the fistula into the bowel may cause rectal passage of urine. Causes
Many causes exist including:
diverticulitis : most common ~ 60%
colorectal cancer (CRC) : ~ 20%
Crohns disease : ~ 10%
radiotherapy
appendicitis
trauma

Diagnosis
Various modalities of diagnosis are available:
Cystoscopy
Colonoscopy
Poppy seed test
Transabdominal ultrasonography
Abdominopelvic CT
MRI
Barium enema
Bourne test
CystogramA definite algorithm of tests is followed for making the diagnosis. See also
Gouverneur’s syndrome

References


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