Long-acting cabotegravir plus rilpivirine in people with HIV aged ≥ 60 years: persistence, virological outcomes, and comorbidity burden in the spanish RELATIVITY Cohort
Year: 2026
Type: article
Abstract: Evidence on long-acting cabotegravir plus rilpivirine (CAB + RPV LA) in older people with HIV (PWH) remains limited. We evaluated virological outcomes, treatment persistence and injection-schedule adherence by age. This nationwide ambispective RELATIVITY cohort analysis compared virologically suppressed adults aged ≥ 60 and < 60 years who initiated CAB + RPV LA by 31 December 2024. Persistence was assessed using Kaplan–Meier estimates and multivariable Cox regression, including an exploratory age-by-comorbidity interaction. Among 3,349 participants at 53 centers, 407 (12.2%) were aged ≥ 60 years (median, 63.0; interquartile range, 61.0–66.8); 349 were aged 60–69, 54 aged 70–79 and four aged ≥ 80. Older participants had more comorbidities (median, 2 vs. 0), longer prior antiretroviral exposure (18 vs. 9 years) and median follow-up of 26.5 versus 25.1 months. Observed virological suppression was 97.3% versus 96.5%, virological failure 0.2% versus 0.9%, and definitive discontinuation 11.3% versus 11.0%. Age ≥ 60 was not clearly associated with discontinuation after adjustment (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.63–1.36). The exploratory age-by-comorbidity interaction HR was 1.34 (1.07–1.67); the older-group HR per comorbidity was 1.20 (0.99–1.46). Injection-schedule adherence ≥ 90% was observed in 99.5% versus 99.3%. CAB + RPV LA showed high observed virological suppression, persistence and injection-schedule adherence in selected PWH aged ≥ 60 years. Age ≥ 60 showed no clear independent association with definitive discontinuation. Comorbidity burden may inform closer follow-up, although this exploratory finding requires confirmation. Evidence remains limited in those aged ≥ 70 years. ClinicalTrials.gov, NCT07703748.
Authors: Jesús Troya, Noemí Cabello-Clotet, Carmen Busca, María José Galindo, Rosa María Martínez, María Remedios Alemán, María de Lagarde, Miguel Torralba, María José Crusells, Francisco Fanjul, Adrián Rodríguez, Paula Runza, Laura Gisbert, Carmen Hidalgo-Tenorio, Luis Enrique Morano, Inmaculada Poquet-Catalá, Juan Tiraboschi, Alberto Romero, Antonia Alcaraz, Eva María Ferreira, Sara García, José Sanz, Patricia Noemí Barragán, Marta Millán, Luis Buzón-Martín
Institutions: Hospital Universitario Infanta Leonor, Hospital Clínico San Carlos, Hospital Universitario La Paz, Hospital Clínico Universitario de Valencia, Hospital Universitario Miguel Servet, Hospital Universitario de Canarias, Hospital Universitario 12 De Octubre, Hospital Universitario de Guadalajara, Hospital Clínico Universitario Lozano Blesa, Hospital Universitario Son Espases, Hospital Son Llatzer, Marqués de Valdecilla University Hospital, University Hospital Mútua de Terrassa, Hospital Universitario Virgen de las Nieves, University Hospital Complex Of Vigo, Bellvitge University Hospital, Hospital Universitario Puerto Real, Hospital General Universitario Morales Meseguer, Hospital General De Segovia, Hospital Santa Caterina, Hospital Universitario Príncipe de Asturias, Pius Hospital de Valls, Hospital Universitario de Burgos
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,490
OpenAlex ID: W7225430251