{
  "abstract": "Backgorund Real-world data on cardiometabolic changes in people with HIV (PWH) switching to long-acting cabotegravir + rilpivirine (LA CAB+RPV) are still limited. The objective of the study was to explore cardiometabolic outcomes and body composition in PWH switching to LA or remaining on oral two-drug regimens (2DR).Methods This was a retrospective longitudinal cohort study including antiretroviral therapy (ART)-experienced PWH. PWH were divided into two groups (LA CAB+RPV) and oral dual therapy (2DR). Inclusion required at least one pre- and post-switch evaluation in the LA group or at least two evaluations in oral 2DR group. 2DR regimens included the following combinations: DTG/3TC, DTG/RPV, DOR + DTG, DOR + RAL, RPV + RAL. PWH receiving boosted protease inhibitors or obsolete regimens such as EFV or ETR based therapies were excluded. Baseline was the last visit before switch and follow-up the last available post-switch visit. The primary outcome was change in body composition including visceral adipose tissue (VAT), lean mass, fat mass, and femoral and lumbar bone mineral density (BMD). Secondary outcomes included waist-to-height ratio, body mass index (BMI), insulin resistance assessed with HOMA-IR, and liver steatosis measured with CAP.Results A total of 617 people with HIV were included, 69 in the LA CAB+RPV group and 548 in the oral 2DR group. Median age was 53 years (IQR 47–60) in the LA group and 58 years (IQR 52–62) in the oral 2DR group. Most participants were male, accounting for 81% in the LA group and 72% in the oral 2DR group, while females represented 19% and 28%, respectively. At baseline, cardiometabolic parameters including BMI, waist circumference, lipids, HOMA-IR, VAT, liver steatosis, and SCORE2 were overall comparable between groups, with no major differences observed. Median follow-up time was 18 months (Q1, Q3: 4.5, 24.1). Changes from baseline to follow-up were largely comparable between groups ( table 1). No significant between-group differences were observed in BMI, waist circumference, HOMA-IR, HbA1c, lipid profile, visceral adipose tissue, total fat mass, total lean mass, femoral BMD, SCORE2, CAP, or liver stiffness (all p>0.05). A greater reduction in lumbar spine BMD was observed in LA-CAB + RPV group compared with oral 2DR (Δ −0.01 ± 0.04 vs 0 ± 0.06, p=0.043). Overall, cardiometabolic and body composition trajectories were similar between groups over follow-up.Conclusions Switching to LA CAB+RPV showed a cardiometabolic profile comparable to oral 2DR, with no meaningful differences in adiposity, metabolic parameters, or liver outcomes. The small reduction in lumbar spine BMD observed with LA therapy was statistically significant but of limited magnitude. Overall, these real-world data support LA CAB+RPV as a metabolically neutral switch strategy in ART-experienced PWH.Abstract P132 Table 1Delta changes between baseline and follow-up in the two groups",
  "authors": [
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "F Calandra Buonaura"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "J Milic"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "S Generoso"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "E Delmonte"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "U Calvi"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "F Buffagni"
    },
    {
      "affiliations": [
        "Infectious Diseases Clinic, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy"
      ],
      "name": "M Menozzi"
    },
    {
      "affiliations": [
        "Infectious Diseases Clinic, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy"
      ],
      "name": "G Cuomo"
    },
    {
      "affiliations": [
        "Infectious Diseases Clinic, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy"
      ],
      "name": "G Mancini"
    },
    {
      "affiliations": [
        "Infectious Diseases Clinic, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy"
      ],
      "name": "M Menozzi"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "C Mussini"
    },
    {
      "affiliations": [
        "Modena HIV Metabolic Clinic, University of Modena and Reggio Emilia, Modena, Italy"
      ],
      "name": "G Guaraldi"
    }
  ],
  "title": "P132 Cardiometabolic outcomes and body composition in PWH switching to LA-CAB/RPV vs. oral 2DR regimens",
  "uid": "0cc95cf9-d471-5f08-9238-b2a7fdd5ae40"
}