P-358. Long-Acting Cabotegravir and Rilpivirine in People Living with HIV and Obesity: Real-World Insights from the RELATIVITY Cohort

Abstract Background Long-acting injectable cabotegravir and rilpivirine (LAI CAB+RPV) is a well-established regimen for people living with HIV (PLWH), offering high efficacy and tolerability. However, data are limited for individuals with a body mass index (BMI) > 30 kg/m², which may represent a potential risk factor for virological failure. Survival curves for virological failure by baseline BMI category in patients on LAI CAB+RPV. Methods We conducted a multicenter, retro-prospective study (RELATIVITY cohort in Spain) of virologically suppressed PLWH switching to LAI CAB+RPV, with a BMI > 30. We described this population and evaluated factors associated with virological outcomes using Kaplan–Meier analysis. Results A total of 3,203 patients were included in the study: 37 (1.2%) were underweight, 879 (27.5%) had normal weight, 807 (25.2%) were overweight, and 279 (8.7%) were obese (BMI >30). The obese group was significantly older (47 vs. 44 years; p < 0.001) and had a higher proportion of women compared to the normal-weight group (22.3% vs. 14.5%; p < 0.001). Foreign nationality was also more frequent among obese individuals (33.6% vs. 27%; p = 0.028). Comorbidities increased significantly with higher BMI: hypertension (8.3% to 21.5%), diabetes (3.8% to 10.4%), dyslipidemia (17.6% to 36.2%), and non-alcoholic fatty liver disease (1.4% to 6.1%) (p < 0.001 for all comparisons). The most frequent reasons for switching were treatment simplification (25.4%) and improvement in quality of life (55.6%). Standard needles were used in 68.7% of individuals with a BMI >30. Kaplan–Meier analysis revealed no statistically significant differences in time to virological failure across BMI groups, although individuals with obesity showed a non-significant trend toward higher failure rates after 12 months. Cox regression analysis also confirmed the absence of an association. Four individuals (1.4%) in the obese group experienced virological failure, with emergent resistance mutations detected in only one case (L100I, K103N, L74M, T97A, G140S, Q148K, Q148R, E157Q). Discontinuation rates were similar across groups, including those related to local (1.8%) and systemic (1.1%) adverse events. Conclusion In real-world settings, LAI CAB+RPV appears to be a viable option for individuals with a BMI > 30 kg/m², demonstrating efficacy and safety rates comparable to those observed in other real-world cohorts. Disclosures All Authors: No reported disclosures

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Journal
Open Forum Infectious Diseases
Published
2026-01-01
DOI
https://doi.org/10.1093/ofid/ofaf695.576
Primary Topic
HIV-related health complications and treatments
Type
article
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article

P-358. Long-Acting Cabotegravir and Rilpivirine in People Living with HIV and Obesity: Real-World Insights from the RELATIVITY Cohort

Inmaculada Poquet, A. Carolina Rodríguez, Juan Carlos Gainzarain, C. Hidalgo et al.
Open Forum Infectious Diseases
HIV-related health complications and treatments
article

P-358. Long-Acting Cabotegravir and Rilpivirine in People Living with HIV and Obesity: Real-World Insights from the RELATIVITY Cohort

Inmaculada Poquet, A. Carolina Rodríguez, Juan Carlos Gainzarain, C. Hidalgo, Noemí Cabello, Cristina Escrich, Beatriz Valentín, María del Carmen Navarro, Jara Llenas, Alberto Romero, J E Losa, Claudia González, María Antonia Sepúlveda, Bárbara Alonso, Luis Miguel Buzón-Martín, Guillermo Soria, María del Carmen Montero, María Aguilera, M Alcaraz, María Ángeles Garcinuño, Lucia Yunquera Romero, Juan José Corte, Jesús Troya, Rafael Micán, Víctor Arenas, Miriam Estébanez, Isabel Sanjoaquin, Alfonso Cabello, Rebeca Cabo, Mireia Cairó, Nuria Vázquez, Eva María Ferreira, Miguel Alberto de Zárraga, José Sanz, Francisco Fanjul, Enrique Bernal, Luis Enrique Morano, Otilia Bisbal, Magdalena Muelas, Juan Tiraboshi, Sara García, María Jesús Vivancos, Ruth Caballero, Marisa Montes, Clara Martínez
article en

Abstract

Abstract Background Long-acting injectable cabotegravir and rilpivirine (LAI CAB+RPV) is a well-established regimen for people living with HIV (PLWH), offering high efficacy and tolerability. However, data are limited for individuals with a body mass index (BMI) > 30 kg/m², which may represent a potential risk factor for virological failure. Survival curves for virological failure by baseline BMI category in patients on LAI CAB+RPV. Methods We conducted a multicenter, retro-prospective study (RELATIVITY cohort in Spain) of virologically suppressed PLWH switching to LAI CAB+RPV, with a BMI > 30. We described this population and evaluated factors associated with virological outcomes using Kaplan–Meier analysis. Results A total of 3,203 patients were included in the study: 37 (1.2%) were underweight, 879 (27.5%) had normal weight, 807 (25.2%) were overweight, and 279 (8.7%) were obese (BMI >30). The obese group was significantly older (47 vs. 44 years; p < 0.001) and had a higher proportion of women compared to the normal-weight group (22.3% vs. 14.5%; p < 0.001). Foreign nationality was also more frequent among obese individuals (33.6% vs. 27%; p = 0.028). Comorbidities increased significantly with higher BMI: hypertension (8.3% to 21.5%), diabetes (3.8% to 10.4%), dyslipidemia (17.6% to 36.2%), and non-alcoholic fatty liver disease (1.4% to 6.1%) (p < 0.001 for all comparisons). The most frequent reasons for switching were treatment simplification (25.4%) and improvement in quality of life (55.6%). Standard needles were used in 68.7% of individuals with a BMI >30. Kaplan–Meier analysis revealed no statistically significant differences in time to virological failure across BMI groups, although individuals with obesity showed a non-significant trend toward higher failure rates after 12 months. Cox regression analysis also confirmed the absence of an association. Four individuals (1.4%) in the obese group experienced virological failure, with emergent resistance mutations detected in only one case (L100I, K103N, L74M, T97A, G140S, Q148K, Q148R, E157Q). Discontinuation rates were similar across groups, including those related to local (1.8%) and systemic (1.1%) adverse events. Conclusion In real-world settings, LAI CAB+RPV appears to be a viable option for individuals with a BMI > 30 kg/m², demonstrating efficacy and safety rates comparable to those observed in other real-world cohorts. Disclosures All Authors: No reported disclosures

Open Forum Infectious DiseasesVol. 13(Supplement_1)
Catholic University of Ávila (ES), Hospital Universitario de Canarias (ES), Hospital Universitario La Paz (ES), Bellvitge University Hospital (ES), ProMedica Toledo Hospital (US), University Hospital Complex Of Vigo (ES), Hospital General Universitario Gregorio Marañón (ES), Hospital Clínico San Carlos (ES), Hospital General De Segovia (ES), Hospital Universitario San Agustín (ES), Hospital Son Llatzer (ES), Hospital Universitario de Torrejón (ES), Hospital General Universitario Morales Meseguer (ES), Hospital Universitari Sant Joan D'Alacant (ES), Hospital Universitario de Guadalajara (ES), Hospital Clínico Universitario de Valencia (ES), University Hospital Mútua de Terrassa (ES), Hospital de Viladecans (ES), Marqués de Valdecilla University Hospital (ES), Hospital Universitario Fundación Alcorcón (ES), Hospital Universitario 12 De Octubre (ES), Hospital Universitario Puerta de Hierro Majadahonda (ES), Hospital Doctor José Molina Orosa (ES), Hospital Universitario Príncipe de Asturias (ES), Hospital Universitario Araba (ES), Instituto de Investigación Biosanitaria de Granada (ES), Hospital Universitario Miguel Servet (ES), Hospital Universitario de Burgos (ES), Hospital General Universitario de Elche (ES), Hospital Universitario Virgen de las Nieves (ES), Hospital Universitario HM Madrid (ES), Hospital Santa Caterina (ES), Junta de Castilla y León (ES), Hospital de Sabadell (ES), Hospital Universitario Fundación Jiménez Díaz (ES), Mútua Terrassa (ES), Hospital Reina Sofía de Murcia (ES), Hospital Universitario de La Princesa (ES), Hospital Universitario Central de Asturias (ES), Hospital Clínico Universitario Lozano Blesa (ES), Hospital Universitario Puerto Real (ES), Servicio de Salud de Castilla La Mancha (ES), Hospital Universitario de Fuenlabrada (ES), Hospital Universitario De Cabueñes (ES), Hospital Vega Baja (ES), Hospital Universitari de Tortosa Verge de la Cinta (ES), Hospital Universitario Son Espases (ES), Hospital Marina Baixa (ES), Hospital Clínico Universitario de Valladolid (ES), Hospital Universitario Río Hortega (ES), Complejo Hospitalario de Pontevedra (ES), Hospital Universitario Ramón y Cajal (ES), Complejo Hospitalario Universitario de Toledo (ES), Hospital Central de la Defensa Gómez Ulla (ES), Hospital Universitario Infanta Leonor (ES)
Good health and well-being
Openalex Percentile: Top 93%
HIV-related health complications and treatments
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