4CPS-189 Real-world effectiveness, safety and adherence of long-acting cabotegravir and rilpivirina in a tertiary hospital
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Long-acting (LA) intramuscular therapy with cabotegravir (CAB) and rilpivirina (RPV) has demonstrated to be an alternative to daily oral regimens. Aim and Objectives To assess clinical effectiveness of switching from an oral regimen to CAB+RPV LA in HIV patients at 6 and 12 months. Secondarily, safety and impact on adherence were evaluated. Material and Methods Observational, retrospective and single-centre (tertiary hospital) study. We included patients who switched to CAB+RPV LA between January 2023 and March 2024. Demographic and laboratory data, previous resistance studies and prior treatment adherence were recorded. At 6 and 12 months, viral load (VL), CD4 counts, adherence and medication-related issues were documented. Effectiveness was determined by VL and CD4 counts. Safety was measured by the number of reported adverse events (AEs) and percentage of discontinuations. Data were obtained from the hospital eVIHA cohort. Results Seventy-one patients were included (82% male, median age 46 (IQR 38–55) years). Time of HIV-1 infection was 14 (IQR 8.2–18.5) years. Median follow-up was 11.6 (IQR 8.8–15.8) months. Four patients had previous resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) and one patient to integrase inhibitors (INIs). 43 (60%) patients had no previous resistance studies. VL was consistently <20 copies/ml across all time points. Median CD4 count was 848 (IQR 738–1189) cells/µl at the start of treatment, 937 (IQR 767–1225) cells/µl at 6 months (p<0.05), and 981 (IQR 724–1160) cells/µl at 12 months (p=0.3). Prior adherence was >90% in 66 (92%) patients. Adherence to CAB+RPV LA was >90% in 66 (92%) patients at 6 months and in 28 (93%) patients at 12 months, differing those from non-adherent patients to oral treatment. A total of 31 (44%) patients reported AEs. The most frequent were local issues (20), flu-like symptoms (7), and neurological reactions (6). Eight (11%) patients discontinued treatment, all due to AEs. Conclusion and Relevance Real-world CAB+RPV LA data show its effectiveness in maintaining viral suppression and adequate CD4 levels. However, we have seen a significant percentage of discontinuations due to AEs that differ from data reported in trials. We also noticed changes in patient adherence patterns. Further studies with a larger number of patients would be necessary to confirm these findings. References and/or Acknowledgements Conflict of Interest No conflict of interest
Authors: S Manso Anda, A Martinez Suarez, M Gomez Zamora, A Gomez Lobon, B Chaves Martinez, RA Freites Navas, T Garcia Ruiz, MM Santandreu Estelrich, C Martorell Puigserver
Institution: Hospital Universitario Son Espases
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408376710