393. Long-Acting Injectable Cabotegravir and Rilpivirine in the Aging HIV Population: Insights from the RELATIVITY Cohort
Year: 2026
Type: article
Abstract: Background Long-acting injectable cabotegravir and rilpivirine (LAI CAB+RPV) has become a standard treatment option for people living with HIV (PLWH), offering high efficacy, safety, and convenience. However, data from clinical trials and real-world cohorts involving people over 60 - an important and growing population with physiological differences and emerging comorbidities - remain scarce. Virological Efficacy Over Time by Age Group Among PLWH on LAI CAB+RPV. Methods We conducted a multicenter, retro-prospective study within the Spanish RELATIVITY cohort, analyzing virologically suppressed PLWH aged ≥60 years who transitioned to LAI CAB+RPV. We described this population and evaluated factors associated with virological outcomes using Kaplan–Meier analysis and Cox proportional hazards models. Results This substudy included 380 PLWH from 58 Spanish hospitals (11.8% of the RELATIVITY cohort). The median age was 63 years (IQR, 61–67); 78% were male, and 90.3% were Spanish nationals. Comorbidities were present in 79.5% of participants, with dyslipidemia (51.6%), hypertension (36.3%), and osteoporosis (15%) being the most common. The median time on ART prior to switching was 18 years (IQR, 11–25), and the median duration of sustained viral suppression was 11 years (IQR, 6.3–17). The main reasons for switching to LAI CAB+RPV were to improve comfort or quality of life (51.7% in those < 60 years vs. 45.8% in those ≥60 years; p = 0.034) and treatment simplification (23.6% vs. 25.5%; p = 0.436). Virological success exceeded 96.5% across all age groups, with a low virological failure rate observed in the older population (0.8%; p = 0.844). Age was not significantly associated with virological failure in either Kaplan–Meier or Cox proportional hazards analyses (HR, 0.996; 95% CI, 0.962–1.031; p = 0.814). Discontinuation rates for any cause were similar between groups (5.2% vs. 5.8%; p = 0.873). No statistically significant differences were found in adverse event rates (0.8% vs. 1.6%; p = 0.335), including injection site reactions (1.4% vs. 1.3%; p = 0.801). Conclusion In a real-world setting, LAI CAB+RPV is a viable and effective treatment option for people over 60 living with long-standing HIV infection and multiple comorbidities. The regimen demonstrated excellent virological control and was well-tolerated across all age groups. Disclosures All Authors: No reported disclosures
Source: Open Forum Infectious Diseases
Authors: Jesús Troya, Carmen Busca, María José Galindo, María Lagarde, Daniel Rodríguez, Miguel Torralba, Alberto Díaz de Santiago, Francisco Fanjul, Adrían Rodríguez, Alfonso Cabello, María José Crussels, Sonia Calzado, María Aguilera, Carmen Hidalgo, Luis Enrique Morano, David Vinuesa, Karenina Antelo, Enrique Bernal, Rosa María Martínez, Noemí Cabello, Juan Tiraboshi, María del Carmen Montero, María Jesús Vivancos, Cristina Díez, Guillermo Soria, Desiré Pérez, Laura Gisbert, Alberto Romero, Rebeca Cabo, Josefa Francisca Soler, Maria Antonia Sepúlveda, Cristina Escrich, Antonio Jesús Sánchez, Noelia Ruiz, Eva María Ferreira, Beatriz Valentín, Javier Lopéz-Nieto, Jara Llenas, Albert Gómez, Juan Emilio Losa, Jose Fernando Lluch, José Sanz, Sergio Padila, Hadrián Pernas, Juan José Corte, Ester Sáez, María Ángeles Garcinuño, Miriam Estébanez, María de Mar García, Luis Buzón-Martín
Institutions: Hospital Universitario Infanta Leonor, Hospital Universitario La Paz, Hospital Clínico Universitario de Valencia, Hospital Universitario 12 De Octubre, Hospital Universitario de Canarias, Hospital Universitario de Guadalajara, Hospital Universitario Puerta de Hierro Majadahonda, Hospital Universitario Son Espases, Hospital Son Llatzer, Hospital Universitario Fundación Jiménez Díaz, Hospital Clínico Universitario Lozano Blesa, Corporació Sanitària Parc Taulí, Hospital Universitario de La Princesa, Hospital Universitario Virgen de las Nieves, Hospital Reina Sofía de Murcia, Hospital Universitario Miguel Servet, Bellvitge University Hospital, Hospital Universitario de Torrejón, Hospital Universitario Ramón y Cajal, Hospital General Universitario Gregorio Marañón, Hospital Universitario de Fuenlabrada, Hospital Universitario San Agustín, University Hospital Mútua de Terrassa, Hospital Universitario Puerto Real, Hospital Universitario Central de Asturias, Hospital Universitario De Cabueñes, Complejo Hospitalario Universitario de Toledo, Hospital Universitario de Toledo, Hospital Universitari de Tortosa Verge de la Cinta, Hospital General Universitario Morales Meseguer, Marqués de Valdecilla University Hospital, Hospital Universitario Río Hortega, Hospital de Viladecans, Hospital Santa Caterina, Hospital Universitario Fundación Alcorcón, Hospital Universitario Príncipe de Asturias, Hospital General Universitario de Elche, Complejo Hospitalario de Pontevedra, Hospital Central de la Defensa Gómez Ulla, Hospital Universitario de Burgos
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W7122542028
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