Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data
Abstract Background Long-acting Cabotegravir and Rilpivirine (LA CAB + RPV) shows potential advantages in heavily comorbid and even in viremic people with HIV (PWH). We assessed LA CAB + RPV durability in a cohort of PWH with a high comorbidity burden and adherence issues. Methods Retrospective obse...
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2025-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-10499-0 |
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| author | Valentina Iannone Roberto Rossotti Nicholas Brian Bana Gabriele Cavazza Federico D’Amico Francesca Lombardi Pierluigi Francesco Salvo Gianmaria Baldin Simona Di Giambenedetto Dario Bernacchia Gabriele Pagani Alberto Borghetti Stefano Rusconi |
| author_facet | Valentina Iannone Roberto Rossotti Nicholas Brian Bana Gabriele Cavazza Federico D’Amico Francesca Lombardi Pierluigi Francesco Salvo Gianmaria Baldin Simona Di Giambenedetto Dario Bernacchia Gabriele Pagani Alberto Borghetti Stefano Rusconi |
| author_sort | Valentina Iannone |
| collection | DOAJ |
| description | Abstract Background Long-acting Cabotegravir and Rilpivirine (LA CAB + RPV) shows potential advantages in heavily comorbid and even in viremic people with HIV (PWH). We assessed LA CAB + RPV durability in a cohort of PWH with a high comorbidity burden and adherence issues. Methods Retrospective observational study in two Italian outpatient settings enrolling PWH who switched to LA CAB + RPV from February 2021 to January 2024 in presence of exclusion criteria enlisted in registrational trials or with other worrisome clinical risks. Kaplan-Meier (KM) was used to assess the probability of CAB/RPV discontinuation. Cox regression analysis was used to evaluate potential predictors of discontinuation. Results We enrolled 74 PWH, with a median of 7 injections (IQR 5–9), a median age of 53 years (IQR 45–61), median time of exposure to antiretrovirals of 11 years (IQR 8–18) and median time from HIV diagnosis of 11.8 years (IQR 6.6–18.2). Eleven (14.9%) discontinued LA CAB + RPV mainly for injection-site pain. Of 53 PWH who were undetectable before switch, 37 maintained viral suppression at week 52. We registered only one virological failure at week 12. Twenty-one started injections with unsuppressed viral loads (median 66 cps/ml, IQR 40–215) and 10 (47.6%) achieved viral suppression. Overall probability of discontinuation was 14.9% at week 52. Younger age was protective against discontinuation (HR 0.93, 95%CI 0.88–0.99, p = 0.048). Conclusions Our results support the potential advantages in using LA CAB + RPV in PWH with adherence issues and comorbidities. |
| format | Article |
| id | doaj-art-0c6d3b8f6b644c65bea059df22fa338e |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-0c6d3b8f6b644c65bea059df22fa338e2025-01-26T12:17:07ZengBMCBMC Infectious Diseases1471-23342025-01-012511710.1186/s12879-025-10499-0Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world dataValentina Iannone0Roberto Rossotti1Nicholas Brian Bana2Gabriele Cavazza3Federico D’Amico4Francesca Lombardi5Pierluigi Francesco Salvo6Gianmaria Baldin7Simona Di Giambenedetto8Dario Bernacchia9Gabriele Pagani10Alberto Borghetti11Stefano Rusconi12Department of Healtcare Surveillance and Bioetichs, Section of Infectious Diseases, Catholic University of Sacred HeartDepartment of Infectious Diseases, ASST Grande Ospedale Metropolitano NiguardaDepartment of Infectious Diseases, ASST Grande Ospedale Metropolitano NiguardaDepartment of Infectious Diseases, ASST Grande Ospedale Metropolitano NiguardaDepartment of Infectious Diseases, ASST Grande Ospedale Metropolitano NiguardaDepartment of Healtcare Surveillance and Bioetichs, Section of Infectious Diseases, Catholic University of Sacred HeartDepartment of Healtcare Surveillance and Bioetichs, Section of Infectious Diseases, Catholic University of Sacred HeartDepartment of Medical and Surgical Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Infectious DiseasesDepartment of Healtcare Surveillance and Bioetichs, Section of Infectious Diseases, Catholic University of Sacred HeartClinical and Biomedical Science Department (DIBIC), Infectious Diseases Unit, University of Milan, Legnano General Hospital, ASST Ovest MilaneseClinical and Biomedical Science Department (DIBIC), Infectious Diseases Unit, University of Milan, Legnano General Hospital, ASST Ovest MilaneseDepartment of Clinical and Experimental Medicine, University of PisaClinical and Biomedical Science Department (DIBIC), Infectious Diseases Unit, University of Milan, Legnano General Hospital, ASST Ovest MilaneseAbstract Background Long-acting Cabotegravir and Rilpivirine (LA CAB + RPV) shows potential advantages in heavily comorbid and even in viremic people with HIV (PWH). We assessed LA CAB + RPV durability in a cohort of PWH with a high comorbidity burden and adherence issues. Methods Retrospective observational study in two Italian outpatient settings enrolling PWH who switched to LA CAB + RPV from February 2021 to January 2024 in presence of exclusion criteria enlisted in registrational trials or with other worrisome clinical risks. Kaplan-Meier (KM) was used to assess the probability of CAB/RPV discontinuation. Cox regression analysis was used to evaluate potential predictors of discontinuation. Results We enrolled 74 PWH, with a median of 7 injections (IQR 5–9), a median age of 53 years (IQR 45–61), median time of exposure to antiretrovirals of 11 years (IQR 8–18) and median time from HIV diagnosis of 11.8 years (IQR 6.6–18.2). Eleven (14.9%) discontinued LA CAB + RPV mainly for injection-site pain. Of 53 PWH who were undetectable before switch, 37 maintained viral suppression at week 52. We registered only one virological failure at week 12. Twenty-one started injections with unsuppressed viral loads (median 66 cps/ml, IQR 40–215) and 10 (47.6%) achieved viral suppression. Overall probability of discontinuation was 14.9% at week 52. Younger age was protective against discontinuation (HR 0.93, 95%CI 0.88–0.99, p = 0.048). Conclusions Our results support the potential advantages in using LA CAB + RPV in PWH with adherence issues and comorbidities.https://doi.org/10.1186/s12879-025-10499-0Long acting antiretroviralsPopulation in needComorbiditiesAdherence issuesVirological suppression |
| spellingShingle | Valentina Iannone Roberto Rossotti Nicholas Brian Bana Gabriele Cavazza Federico D’Amico Francesca Lombardi Pierluigi Francesco Salvo Gianmaria Baldin Simona Di Giambenedetto Dario Bernacchia Gabriele Pagani Alberto Borghetti Stefano Rusconi Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data BMC Infectious Diseases Long acting antiretrovirals Population in need Comorbidities Adherence issues Virological suppression |
| title | Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data |
| title_full | Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data |
| title_fullStr | Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data |
| title_full_unstemmed | Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data |
| title_short | Unconventional use of injectable long-acting cabotegravir and rilpivirine against HIV-1 in PWH in clinical need: 52 weeks real-world data |
| title_sort | unconventional use of injectable long acting cabotegravir and rilpivirine against hiv 1 in pwh in clinical need 52 weeks real world data |
| topic | Long acting antiretrovirals Population in need Comorbidities Adherence issues Virological suppression |
| url | https://doi.org/10.1186/s12879-025-10499-0 |
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