Effectiveness and Persistence of Long‐Acting Injectable Cabotegravir and Rilpivirine in Migrant Individuals Living With HIV in Spain: Substudy of the RELATIVITY Cohort

ABSTRACT Introduction Migrants living with HIV often face high mobility, vulnerability and limited baseline information on HIV‐1 genotype or treatment history. We aimed to assess the effectiveness and persistence of long‐acting injectable cabotegravir and rilpivirine (LAI CAB+RPV) among migrants in...

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Autores: Llenas‐García, Jara, Arcos Rueda, María del Mar, Calderón Hernaiz, Ruth, Pedrero Tomé, Roberto, Bisbal Pardo, Otilia, Matarranz, Mariano, Torralba, Miguel, Galindo Puerto, María José, Rodriguez Rodriguez, Adrian, Peñaranda Vera, Maria, Sanjoaquín Conde, Isabel, de la Fuente Moral, Sara, Cabello‑Úbeda, Alfonso, Navarro San Francisco, Carolina, Antelo Cuéllar, Karenina, Pedrosa Aragón, Marc, Aguilera García, María, Tiraboschi, Juan, Martínez Álvarez, Rosa María, Vivancos, María Jesús, Montero Hernández, Carmen, Bernal Morell, Enrique, Cabello‐Clotet, Noemí, Morano Amado, Luis Enrique, Gisbert Pérez, Laura, Sepúlveda, María Antonia, Alemán Valls, María Remedios, Sánchez Guirao, Antonio Jesús, Fanciulli, Chiara, Escrig, Cristina, Ferreira Pasos, Eva María, Lucas‐Dato, Ana, García Torras, Sara, Hidalgo Tenorio, Carmen, Estébanez, Miriam, Muelas‑Fernandez, Magdalena, Losa García, Juan Emilio, Cerezales Calviño, Ana, Pino Díaz, María Elisa, Martínez Montes, Clara, Arenas García, Víctor, Arnaiz de las Revillas, Francisco, Pernas Pardavila, Hadrián, Padilla, Sergio, Garcinuño Jiménez, María Ángeles, Alonso Alonso, Lucía, Ramos Vicente, Noemí, Barragán Gallo, Patricia Noemí, Cabo Magadan, Rebeca, del Álamo, Míkel, Egido Murciano, Miguel Vicente, Juárez Toquero, Alberto, Romero Palacios, Alberto, Clavero Olmos, Marta, García Navarro, María del Mar, Sanz, José, Gainzarain, Juan Carlos, Milian Sanz, Marta, de la Calle, Beatriz, Ferrero Benéitez, Oscar Luis, Troya, Jesús, Buzón‐Martín, Luis
Tipo de recurso: artículo
Fecha de publicación:2026
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:dnet:docusalut___::93a115ac1ef6da1529d6dfa07b3bd6f2
Acceso en línea:https://hdl.handle.net/20.500.13003/27487
Access Level:acceso abierto
Palabra clave:Anti-HIV Agents
Diketopiperazines
HIV Infections
Pyridones
Rilpivirine
Transients and Migrants
Fármacos Anti-VIH
Dicetopiperazinas
Infecciones por VIH
Piridonas
Rilpivirina
Migrantes
HIV
antiretroviral treatment
cabotegravir
effectiveness
health access
long‐acting
migration
persistence
Descripción
Sumario:ABSTRACT Introduction Migrants living with HIV often face high mobility, vulnerability and limited baseline information on HIV‐1 genotype or treatment history. We aimed to assess the effectiveness and persistence of long‐acting injectable cabotegravir and rilpivirine (LAI CAB+RPV) among migrants in Spain. Methods This multicentre cohort study across 58 Spanish hospitals included virologically suppressed adults switching to CAB+RPV LAI before January 2025. Data collection started in June 2023. Baseline characteristics and outcomes were compared by migrant status, and multivariate Cox proportional hazards regression models were fitted to assess factors associated with virological failure (VF) and discontinuation. Propensity score matching (PSM) by gender, age, known genotype and prior VF was employed to control for confounding. Results Of 3135 participants, 951 (30.3%) were migrants, predominantly from Latin America. Median follow‐up was 13.8 months (interquartile range 8.91–19.1). VF occurred in 0.9% of migrants versus 0.5% of Spanish‐born individuals (odds ratio 1.89, 95% confidence interval [CI] 0.69–5.03; p = 0.22). In adjusted models, migrant status showed a non‐significant trend towards higher VF (adjusted hazard ratio [aHR] 2.16, 95% CI 0.89–5.22; p = 0.079). At 12 months, 95.8% of migrants (461/481) persisted on LAI CAB+RPV treatment versus 98.3% of Spanish‐born individuals (1348/1372) ( p = 0.005). Discontinuation due to any adverse event was more frequent in migrants (3.3% vs. 1.8%). Migrant status was significantly associated with discontinuation due to both local (aHR 2.63, 95% CI 1.33–5.26; p = 0.005) and systemic adverse events (aHR 3.33, 95% CI 1.45–7.69, p = 0.005). In the PSM cohort ( n = 932 per group), migrant status was independently associated with increased risk of VF (aHR 3.51, 95% CI 0.95–12.98, p = 0.045) and discontinuation due to systemic adverse events (aHR 2.88, 95% CI 1.01–8.17, p = 0.047). Conclusions Nearly one‐third of participants switching to LAI CAB+RPV were migrants. While VF was rare overall, migrants had a significantly higher risk of treatment discontinuation, partly driven by adverse events. These findings highlight the need for closer monitoring and tailored strategies to optimize persistence with LAI regimens in migrant populations.

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