{
  "abstract": "Background Long-acting injectable antiretroviral therapy with cabotegravir plus rilpivirine (CAB/RPV LA) represents a paradigm shift in the management of HIV-1 infection. Although phase III studies demonstrated non-inferiority compared with daily oral regimens, women remain underrepresented, limiting sex-specific conclusions. Considering that approximately 40,000 women are living with HIV in Italy, real-world data are essential to evaluate effectiveness, safety, and acceptability in this population. We evaluated virological outcomes and tolerability of CAB/RPV LA among women in routine clinical practice.Materials and Methods We conducted a multicenter retrospective cohort study including adult women living with HIV who switched from a stable oral antiretroviral regimen ( table 1) to CAB/RPV LA between October 2022 and December 2025. Eligible participants had documented viral suppression (HIV-1 RNA <50 copies/mL) for at least 6 months prior to switch. Demographic, clinical, and laboratory data were extracted from electronic medical records. Outcomes included maintenance of viral suppression, incidence of virological failure, treatment discontinuations and reasons for discontinuation. Treatment discontinuations were defined as permanent interruption of CAB/RPV LA for clinical or patient-related reasons; transfers of care were censored and not included in discontinuation analyses.Results A total of 122 women were included, with a median age of 51 years; a substantial proportion had BMI ≥30 kg/m 2 (table 2). At week 48, 94.9% maintained virological suppression. Confirmed virological failure occurred in one participant, with no consistent association with BMI; but she successfully re-suppressed the virus by switching back to oral therapy with BIC/TAF/FTC. Excluding transfers of care, 17 women (13.9%) discontinued treatment. The most frequent reason for discontinuation was injection-site reactions (n=8), followed by HBsAg positivity (n=2), logistical challenges (n=1), patient preference (n=1), desire for pregnancy (n=1), and other causes (n=3). Two women became pregnant during follow-up and decide to continue CAB/RPV LA; they delivered while maintaining virological suppression, with no adverse maternal outcomes.Conclusions In this real-world multicenter cohort, long-acting CAB/RPV demonstrated high rates of virological maintenance, favourable tolerability, and good persistence among women. Effectiveness was consistent with pivotal trial data. Viral suppression was maintained in the two pregnancies observed during follow-up, providing preliminary real-world data in this setting. These findings reinforce the importance of generating sex-specific real-world evidence and support CAB/RPV LA as a valuable therapeutic option for women living with HIV.Abstract P140 Table 1Previous oral ART regimensAbstract P140 Table 2Baseline characteristics",
  "authors": [
    {
      "affiliations": [
        "Infectious Diseases Unit, Medical Department, Fondazione IRCCS Policlinico San Matteo University of Pavia, Pavia, Italy"
      ],
      "name": "L Pagnucco"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "MV Cossu"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "M Matone"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "C Mariani"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy"
      ],
      "name": "R Solidoro"
    },
    {
      "affiliations": [
        "Infectious Diseases Unit, Medical Department, Fondazione IRCCS Policlinico San Matteo University of Pavia, Pavia, Italy"
      ],
      "name": "MA Muslimani"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy",
        "DIBIC Luigi Sacco, University of Milan, Italy"
      ],
      "name": "A Riva"
    },
    {
      "affiliations": [
        "Infectious Diseases Unit, Medical Department, Fondazione IRCCS Policlinico San Matteo University of Pavia, Pavia, Italy"
      ],
      "name": "R Gulminetti"
    }
  ],
  "title": "P140 Real-world effectiveness and treatment persistence of long-acting cabotegravir/rilpivirine in women living with HIV",
  "uid": "466d6e28-3c4b-5049-b141-aa2e6c3e80e6"
}