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Switching to long-acting cabotegravir/rilpivirine:
data from an Italian monocentric cohort
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August 09, 2024.
Abstract
Background:
Cabotegravir/Rilpivirine (CAB/RPV) is the first long-acting injectable (LAI) antiretroviral therapy approved for virologically suppressed adults with HIV-1.
Setting:
Italian single centre cohort.
Methods:
We conducted a retrospective observational study to assess the durability, adherence to the prescribed injection schedule, and reasons for discontinuation of CAB/RPV LAI administered every 8 weeks (Q8W).
Results:
One hundred and thirty-eight patients were included with a median observation period of 43 weeks (IQR 34-47). Of these, 32 (23.2%) were female, and the median age was 51 years old (IQR 40-58). Twelve patients (8.7%) discontinued CAB/RPV LAI treatment with a median time to discontinuation of 21 weeks (IQR 12-35). 92.8% of the injections occurred within the CAB/RPV LAI schedule. The most common reason for discontinuation was injection-related pain (5/12). No confirmed virological failure occurred during the period of observation with 3 individuals who experienced virological blips.
Reasons for discontinuation among these 12 individuals included injection-related pain (n=5), evidence of HBV infection retrospectively identified post-initiation of CAB/RPV LAI (n=1), clinical decision after an episode of major depression (n=1), pregnancy (n=1), implant of silicon prosthesis (n=1), drug-drug interactions (n=1), evidence of rilpivirine resistance-associated mutations (RAMs) after re-exam of genotypic resistance test (n=1), and logistic reasons (n=1). We recorded 3 (2.2%) virological blips (all< 200 cp/mL) and no virological failures during the study period.
Conclusions:
Our findings showed that CAB/RPV LAI Q8W is well-tolerated in clinical practice, with high adherence to the injection schedule and few discontinuations mainly related to injection site related pain.
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