393. Long-Acting Injectable Cabotegravir and Rilpivirine in the Aging HIV Population: Insights from the RELATIVITY Cohort

Abstract Background Long-acting injectable cabotegravir and rilpivirine (LAI CAB+RPV) has become a standard treatment option for people living with HIV (PLWH), offering high efficacy, safety, and convenience. However, data from clinical trials and real-world cohorts involving people over 60 - an important and growing population with physiological differences and emerging comorbidities - remain scarce. Virological Efficacy Over Time by Age Group Among PLWH on LAI CAB+RPV. Methods We conducted a multicenter, retro-prospective study within the Spanish RELATIVITY cohort, analyzing virologically suppressed PLWH aged ≥60 years who transitioned to LAI CAB+RPV. We described this population and evaluated factors associated with virological outcomes using Kaplan–Meier analysis and Cox proportional hazards models. Results This substudy included 380 PLWH from 58 Spanish hospitals (11.8% of the RELATIVITY cohort). The median age was 63 years (IQR, 61–67); 78% were male, and 90.3% were Spanish nationals. Comorbidities were present in 79.5% of participants, with dyslipidemia (51.6%), hypertension (36.3%), and osteoporosis (15%) being the most common. The median time on ART prior to switching was 18 years (IQR, 11–25), and the median duration of sustained viral suppression was 11 years (IQR, 6.3–17). The main reasons for switching to LAI CAB+RPV were to improve comfort or quality of life (51.7% in those < 60 years vs. 45.8% in those ≥60 years; p = 0.034) and treatment simplification (23.6% vs. 25.5%; p = 0.436). Virological success exceeded 96.5% across all age groups, with a low virological failure rate observed in the older population (0.8%; p = 0.844). Age was not significantly associated with virological failure in either Kaplan–Meier or Cox proportional hazards analyses (HR, 0.996; 95% CI, 0.962–1.031; p = 0.814). Discontinuation rates for any cause were similar between groups (5.2% vs. 5.8%; p = 0.873). No statistically significant differences were found in adverse event rates (0.8% vs. 1.6%; p = 0.335), including injection site reactions (1.4% vs. 1.3%; p = 0.801). Conclusion In a real-world setting, LAI CAB+RPV is a viable and effective treatment option for people over 60 living with long-standing HIV infection and multiple comorbidities. The regimen demonstrated excellent virological control and was well-tolerated across all age groups. 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/ofaf695.131
Primary Topic
HIV-related health complications and treatments
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article
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article

393. Long-Acting Injectable Cabotegravir and Rilpivirine in the Aging HIV Population: Insights from the RELATIVITY Cohort

A. Carolina Rodríguez, Reinaldo Martinez, David Pazo Vinuesa, D. Queimaliños Pérez et al.
Open Forum Infectious Diseases
HIV-related health complications and treatments
article

393. Long-Acting Injectable Cabotegravir and Rilpivirine in the Aging HIV Population: Insights from the RELATIVITY Cohort

A. Carolina Rodríguez, Reinaldo Martinez, David Pazo Vinuesa, D. Queimaliños Pérez, Hadrián Pernas, Javier López-Nieto, C. Hidalgo, Noemí Cabello, Cristina Escrich, Beatriz Valentín, Karenina Antelo, Daniel Rodríguez, Ester Miralles Sáez, Jara Llenas, Antonio Jesús Sánchez, Alberto Romero, J E Losa, María Antonia Sepúlveda, Luis Miguel Buzón-Martín, Guillermo Soria, María del Carmen Montero, María Aguilera, María Ángeles Garcinuño, Juan José Corte, María José Crussels, Jesús Troya, Miriam Estébanez, María Lagarde, Alfonso Cabello, Rebeca Cabo, Eva María Ferreira, Noelia Ruiz, Alberto Díaz de Santiago, José Sanz, Francisco Fanjul, Jose Fernando Lluch, Enrique Bernal, Sonia Calzado, Cristina Díez, Sergio Padila, Luis Enrique Morano, Juan Tiraboshi, María Jesús Vivancos, Albert Gómez, Laura Gisbert, María de Mar García, Josefa Francisca Soler
article en

Abstract

Abstract Background Long-acting injectable cabotegravir and rilpivirine (LAI CAB+RPV) has become a standard treatment option for people living with HIV (PLWH), offering high efficacy, safety, and convenience. However, data from clinical trials and real-world cohorts involving people over 60 - an important and growing population with physiological differences and emerging comorbidities - remain scarce. Virological Efficacy Over Time by Age Group Among PLWH on LAI CAB+RPV. Methods We conducted a multicenter, retro-prospective study within the Spanish RELATIVITY cohort, analyzing virologically suppressed PLWH aged ≥60 years who transitioned to LAI CAB+RPV. We described this population and evaluated factors associated with virological outcomes using Kaplan–Meier analysis and Cox proportional hazards models. Results This substudy included 380 PLWH from 58 Spanish hospitals (11.8% of the RELATIVITY cohort). The median age was 63 years (IQR, 61–67); 78% were male, and 90.3% were Spanish nationals. Comorbidities were present in 79.5% of participants, with dyslipidemia (51.6%), hypertension (36.3%), and osteoporosis (15%) being the most common. The median time on ART prior to switching was 18 years (IQR, 11–25), and the median duration of sustained viral suppression was 11 years (IQR, 6.3–17). The main reasons for switching to LAI CAB+RPV were to improve comfort or quality of life (51.7% in those < 60 years vs. 45.8% in those ≥60 years; p = 0.034) and treatment simplification (23.6% vs. 25.5%; p = 0.436). Virological success exceeded 96.5% across all age groups, with a low virological failure rate observed in the older population (0.8%; p = 0.844). Age was not significantly associated with virological failure in either Kaplan–Meier or Cox proportional hazards analyses (HR, 0.996; 95% CI, 0.962–1.031; p = 0.814). Discontinuation rates for any cause were similar between groups (5.2% vs. 5.8%; p = 0.873). No statistically significant differences were found in adverse event rates (0.8% vs. 1.6%; p = 0.335), including injection site reactions (1.4% vs. 1.3%; p = 0.801). Conclusion In a real-world setting, LAI CAB+RPV is a viable and effective treatment option for people over 60 living with long-standing HIV infection and multiple comorbidities. The regimen demonstrated excellent virological control and was well-tolerated across all age groups. 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), 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 del Vinalopó (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 92%
HIV-related health complications and treatments
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