Clinical outcomes of long-acting cabotegravir and rilpivirine in people with HIV aged 60 and older: Real-world data from the Spanish RELATIVITY cohort
Background Long-acting injectable cabotegravir and rilpivirine (LAI CAB + RPV) is an established maintenance strategy for people with HIV who are virologically suppressed, providing high efficacy and convenience in treatment. However, evidence in older adults (>= 60 years), a growing and complex...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Consejo Superior de Investigaciones Científicas (CSIC) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p19572 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/19572 |
| Access Level: | acceso abierto |
| Palabra clave: | aging cabotegravir plus rilpivirine HIV long-acting injectable real-world study virological suppression |
| Sumario: | Background Long-acting injectable cabotegravir and rilpivirine (LAI CAB + RPV) is an established maintenance strategy for people with HIV who are virologically suppressed, providing high efficacy and convenience in treatment. However, evidence in older adults (>= 60 years), a growing and complex population, is limited. Methods We conducted an ambispective real-world sub-analysis of the Spanish RELATIVITY cohort, including people with HIV aged >= 60 years who initiated LAI CAB + RPV across 58 centres. Outcomes (virological suppression, safety, discontinuation and adherence) were compared with those <60 years of age using Kaplan-Meier and Cox models. Results Among the 3146 participants, 370 (11.8%) were aged >= 60 years (median age 63.0 [61.0, 67.0]; 78.3% male). Older adults had longer ART exposure (median 18.0 [11.0, 25.0] years), more comorbidities (79.5%) and lower historical CD4 nadirs than younger adults. After 15 months of follow-up, the rates of virological suppression remained high and comparable between the groups (97.3% in those aged >= 60 years vs. 96.8% in those <60 years), with very low protocol-defined virological failure rates (0.3% vs. 0.7%). Discontinuations (7.8% vs. 6.1%) and adverse events (1.6% vs. 0.8%) were infrequent and showed no significant differences between age groups. Adherence to injection visits was excellent, with >89% of the participants aged >= 60 years demonstrating perfect adherence. Conclusion In this large multicentre real-world sub-study, LAI CAB + RPV maintained virological control and showed good tolerability in older people with HIV despite high multi-morbidity and long-term ART exposure. These findings extend the evidence from previous trials and support LAI CAB + RPV as a feasible option for geriatric HIV care. Longer follow-up will provide further insights into durability and quality-of-life benefits. |
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