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Updated: May 29, 2025

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
Transient Viremia Among People with HIV Receiving Injectable Cabotegravir Plus Rilpivirine
Lauren F O'Connor1, Wei Li Adeline Koay2,3, Justin Unternaher2
1Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA.
Long-acting injectable cabotegravir/rilpivirine is effective for people with HIV. Higher baseline CD4 counts are linked to fewer virologic blips, which are transient increases in HIV RNA.
Area of Science:
- Infectious Diseases
- Virology
- Pharmacology
Background:
- Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) offers an effective HIV treatment.
- Virologic blips (VB), transient increases in HIV RNA, can occur in patients on LAI CAB/RPV.
- Risk factors for VB in this population are not well understood.
Purpose of the Study:
- To describe a cohort of people with HIV (PWH) on LAI CAB/RPV.
- To evaluate risk factors for and time to VB after initiating LAI CAB/RPV.
- To identify clinical factors associated with VB occurrence.
Main Methods:
- Analysis of DC Cohort data for PWH initiating LAI CAB/RPV before July 2023.
- Kaplan-Meier curves and Cox proportional hazards models used to assess time to VB.
- Evaluation of demographic and HIV clinical factors, including CD4 counts.
Main Results:
- Nine out of 98 (9.2%) PWH experienced at least one VB during a median follow-up of five months.
- A high CD4 count (≥ 500 cells/µL) at initiation was associated with a significantly lower hazard for VB (aHR: 0.07; 95% CI: 0.01, 0.50).
- No other factors were significantly associated with time to VB; no virologic failure occurred.
Conclusions:
- Baseline CD4 count is a significant factor influencing VB occurrence in PWH on LAI CAB/RPV.
- Higher CD4 counts at initiation may protect against virologic blips.
- Further research is needed to fully understand VB occurrence and associated factors.
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