Predictors of Discontinuing Injectable Cabotegravir/Rilpivirine and Virologic Outcomes After Resuming Oral Antiretroviral Therapy

Strategic Insights -

Researchers at the University of California have conducted a retrospective cohort study to evaluate factors associated with discontinuation of long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) and describe virologic outcomes in those that returned to oral antiretroviral therapy (ART). The study found that individuals with substance use demonstrated a higher rate of LAI discontinuation, despite the potential benefit from LAIs in this population. The study also identified being male sex assigned at birth and having psychiatric disease as factors associated with continuing LAI CAB/RPV.

Key Takeaways:

  • The study included 92 patients who discontinued LAI CAB/RPV and 346 patients who continued treatment between April 2021 and March 2024.
  • Being male sex assigned at birth and having psychiatric disease were associated with continuing LAI CAB/RPV, whereas having active substance use and being on a multi-class regimen prior to initiation of LAI CAB/RPV was associated with discontinuation.
  • Individuals with substance use demonstrated a higher rate of LAI discontinuation, despite the potential benefit from LAIs in this population.
  • The study found that in those with VL data after resuming oral ART, the percentage of those with HIV VL ≥ 200 copies/mL at 24-48 weeks was 37.5%.
  • The study's results suggest that substance use may be a predictor of LAI discontinuation and that further research is needed to understand the relationship between substance use and LAI discontinuation.
  • The study's findings have implications for the development of effective treatment strategies for individuals with HIV who are at risk of LAI discontinuation.

Statistics:

  • A total of 92 patients were included in the discontinuation cohort (38.2% of the study population).
  • 346 patients continued LAI CAB/RPV during the study period (61.8% of the study population).
  • The percentage of those with HIV VL ≥ 200 copies/mL at 24-48 weeks after resuming oral ART was 37.5%.
  • The study's results suggest that substance use may be a predictor of LAI discontinuation.

Sources:

  • Predictors of discontinuing injectable cabotegravir/rilpivirine and virologic outcomes after resuming oral antiretroviral therapy. HIV Medicine, 2025. HIV Medicine can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - www.wiley.com/; HIV Medicine - onlinelibrary.wiley.com/journal/10.1111/(ISSN)1468-1293)
  • AIDS Weekly. October 27, 2025; p 38.