{
  "abstract": "Background Long-acting injectable cabotegravir/rilpivirine (CAB/RPV LAI) administered every 8 weeks (Q8W) is an established maintenance strategy for virologically suppressed people with HIV (PWH). While clinical trials have demonstrated sustained efficacy through 152 weeks, real-world data with longer follow-up remain limited. We evaluated long-term treatment persistence, injection adherence, and virological outcomes in routine clinical practice.Methods We conducted a retrospective observational study including virologically suppressed PWH who initiated CAB/RPV LAI Q8W at our center between October 2022 and September 2023, with follow-up through December 1, 2025. Treatment durability was assessed using Kaplan–Meier survival analysis, with treatment-related discontinuation as the event of interest. Transfer of care, pregnancy planning, and non-treatment-related deaths were censored. Injection adherence was evaluated by comparing observed versus expected dosing intervals. Virological outcomes included rates of viral suppression, virological blips, and confirmed virological failure.Results A total of 227 PWH were included (median age 51 years [IQR 42–60]; 24.7% female), with a median follow-up of 163 weeks (IQR 152–168); 213 patients (93.8%) reached ≥144 weeks of observation.Treatment Persistence: Treatment-related discontinuation occurred in 20/227 patients (8.8%) (table 1). Kaplan–Meier analysis showed sustained treatment persistence over time, with an estimated probability of remaining on therapy of 92.1% at week 144. Discontinuations were primarily driven by adverse events (n=8), injection fatigue (n=4), and clinical reassessment or other patient-related reasons (n=8).Injection Adherence: Across 5,252 completed dosing intervals, 95.2% were administered within the protocol-defined window (±7 days from scheduled date). The remaining 4.8% (252) were delayed beyond this window: 4.3% by 8–14 days and only 0.5% by more than 14 days. No temporal deterioration in injection timing was observed.Virological Outcomes: Virological suppression remained high, with 99.5% of patients suppressed at both week 96 (n=218) and week 144 (n=206). Twenty-four virological blips were documented in 20 individuals (8.8%); most were transient and did not require treatment modification. Two confirmed virological failures occurred (incidence rate: 0.4/100 person-years).Conclusions Over a median follow-up exceeding three years, CAB/RPV LAI Q8W demonstrated sustained treatment persistence, high adherence to injection schedules, and durable virological suppression in routine clinical practice. These real-world findings support the long-term feasibility and effectiveness of CAB/RPV LAI Q8W beyond clinical trial settings and confirm its durability in unselected patient populations.Abstract P142 Table 1Treatment-related discontinuations and censoring events (N = 227)",
  "authors": [
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy"
      ],
      "name": "MV Cossu"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy"
      ],
      "name": "D Moschese"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy"
      ],
      "name": "M Matone"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy",
        "DIBIC Luigi Sacco, University of Milan",
        "Milan, Italy"
      ],
      "name": "A Giacomelli"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy"
      ],
      "name": "P Olimpia"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy",
        "DIBIC Luigi Sacco, University of Milan",
        "Milan, Italy"
      ],
      "name": "A Riva"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy"
      ],
      "name": "AL Ridolfo"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy"
      ],
      "name": "C Gervasoni"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, ASST Fatebenefratelli Sacco",
        "Milan, Italy",
        "DIBIC Luigi Sacco, University of Milan",
        "Milan, Italy",
        "Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy"
      ],
      "name": "A Gori"
    }
  ],
  "title": "P142 Real-world long-term outcomes of cabotegravir/rilpivirine Q8W with extended follow-up",
  "uid": "6548310e-1b67-5f4a-84ea-06bdf706f205"
}