4CPS-026 Clinical evolution compared between single-tablet regimens and long-acting antiretrovirals after 12 months of treatment

<h3>Background and Importance</h3> Long-acting antiretrovirals (LAAR) are a recently introduced type of intramuscular antiretroviral treatment (ART) that have made it possible to avoid the daily administration of tablets in those patients without prior resistance or virological failure and an undetectable viral load. <h3>Aim and Objectives</h3> Describe whether the clinical and analytical evolution with LAAR (cabotegravir and rilpivirine) is non-inferior to that achieved with STR [Dolutegravir/Lamivudine: (DTG/3TC) or Bictegravir/Emtricitabine/Tenofovir alafenamide: (BIC/FTC/TAF)]. <h3>Material and Methods</h3> To evaluate the effectiveness of CAB+RPV, the clinical and analytical response was analysed through viral loads, CD4/CD8 ratio, and hepatic, lipid, and renal profiles. We followed-up on those patients with a minimum duration of 12 months with LAAR. <h3>Results</h3> We followed-up 67 patients (46 men) undergoing treatment with LAAR, with a mean age of 44.5 years (28–63), all of them with DTG/3TC (32) or BIC/FTC/TAF (35) and at least 1 year of treatment with LAAR. All were classified in stages A2 (14–28% CD4)) and A3 (&lt;14% CD4), except two of them classified as B3. As a condition for switch, everyone had to have an undetectable viral load (&lt;50 cop/ml). Only in six of them was a blip detected and never with VL&gt;200 cop/ml. After at least 1 year of treatment with LAAR, the mean CD4/CD8 ratio was 0.91 (0.5–1.36). The mean renal function was 0.94 mg/dL (0.56–1.76) except for some discordant values, probably due to long-standing old therapies with TDF. The average lipid profile was preserved in its different biomarkers Tc: 168 mg/dL and HDLc: 69 mg/dL, with the exception of LDL-C: 123 mg/dL (&lt;100 mg/dL) and TG: 220 mg/dL (&lt;150 mg/dL). The mean values of GGT, ALT and AST were 128 IU, 45 IU and 69 IU. Only one patient showed a body mass index greater than 30 kg/m2 (17.5–32). 21 patients reported adverse effects in the administration procedure, with intramuscular administration being a painful route. <h3>Conclusion and Relevance</h3> Given our experience after a minimum of 12 months of treatment with LAAR and whose previous treatments have been DTG/3TC and BIC/FTC/TAF, cabotegravir and rilpivirine constitute a suitable alternative for patients with positive HIV infection, maintaining virological suppression and an adequate immunological profile. <h3>References and/or Acknowledgements</h3> GeSIDA: Available in: https://gesida-seimc.org/ <h3>Conflict of Interest</h3> No conflict of interest