Virological Success With Long-Acting Cabotegravir and Rilpivirine Despite Historical Rilpivirine Resistance: A Real-World Case Series

In a case series of 13 individuals with historical rilpivirine (RPV) resistance-associated mutations, predominantly E138A, long-acting cabotegravir/rilpivirine (CAB/RPV) maintained suppression over a median 24-month follow-up. Twelve were virologically suppressed at switch. No virological failures o...

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Bibliographic Details
Authors: Gutiérrez, F, Fernández-González, M, Ledesma, C, García-Abellán, J, Lopez, L, Bello-Perez, M, Padilla, S, García, F, Masiá, M
Format: article
Status:Published version
Publication Date:2025
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p19860
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/19860
Access Level:Open access
Keyword:E138A
long-acting cabotegravir and rilpivirine
NNRTI resistance
rilpivirine mutations
virological failure
Description
Summary:In a case series of 13 individuals with historical rilpivirine (RPV) resistance-associated mutations, predominantly E138A, long-acting cabotegravir/rilpivirine (CAB/RPV) maintained suppression over a median 24-month follow-up. Twelve were virologically suppressed at switch. No virological failures occurred, supporting cautious CAB/RPV use in selected patients with remote or polymorphic mutations. Virologically suppressed individuals with historical rilpivirine resistance-associated mutations maintained suppression after switching to long-acting CAB/RPV, supporting potential use beyond current exclusions, particularly in those with isolated E138A or low-risk resistance profiles.

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