Virological Success With Long-Acting Cabotegravir and Rilpivirine Despite Historical Rilpivirine Resistance: A...

Area of Science:

• Infectious Diseases
• Virology
• Pharmacology

Background:

• Antiretroviral therapy is crucial for managing HIV.
• Long-acting injectable regimens offer new treatment options.
• Understanding treatment outcomes in patients with prior resistance is essential.

Purpose of the Study:

• To evaluate the efficacy of long-acting cabotegravir/rilpivirine (CAB/RPV) in individuals with historical rilpivirine (RPV) resistance mutations.
• To assess viral suppression and virological failure rates during CAB/RPV treatment in this specific population.

Main Methods:

• A case series design was employed.
• The study included 13 individuals with documented historical RPV resistance mutations, primarily E138A.
• Patients were switched to long-acting CAB/RPV, with follow-up data analyzed.

Main Results:

• The median follow-up duration was 24 months.
• Twelve out of 13 participants (92.3%) were virologically suppressed at the time of switching to CAB/RPV.
• No virological failures were observed during the follow-up period.

Conclusions:

• Long-acting CAB/RPV demonstrated sustained viral suppression in patients with historical RPV resistance mutations.
• The findings support the cautious use of CAB/RPV in selected individuals with remote or polymorphic resistance mutations.
• Long-acting injectables may be a viable option for patients with complex treatment histories.