Long-acting cabotegravir plus rilpivirine in people with HIV aged ≥ 60 years: persistence, virological outcomes, and comorbidity burden in the spanish RELATIVITY Cohort

Evidence on long-acting cabotegravir plus rilpivirine (CAB + RPV LA) in older people with HIV (PWH) remains limited. We evaluated virological outcomes, treatment persistence and injection-schedule adherence by age. This nationwide ambispective RELATIVITY cohort analysis compared virologically suppressed adults aged ≥ 60 and < 60 years who initiated CAB + RPV LA by 31 December 2024. Persistence was assessed using Kaplan–Meier estimates and multivariable Cox regression, including an exploratory age-by-comorbidity interaction. Among 3,349 participants at 53 centers, 407 (12.2%) were aged ≥ 60 years (median, 63.0; interquartile range, 61.0–66.8); 349 were aged 60–69, 54 aged 70–79 and four aged ≥ 80. Older participants had more comorbidities (median, 2 vs. 0), longer prior antiretroviral exposure (18 vs. 9 years) and median follow-up of 26.5 versus 25.1 months. Observed virological suppression was 97.3% versus 96.5%, virological failure 0.2% versus 0.9%, and definitive discontinuation 11.3% versus 11.0%. Age ≥ 60 was not clearly associated with discontinuation after adjustment (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.63–1.36). The exploratory age-by-comorbidity interaction HR was 1.34 (1.07–1.67); the older-group HR per comorbidity was 1.20 (0.99–1.46). Injection-schedule adherence ≥ 90% was observed in 99.5% versus 99.3%. CAB + RPV LA showed high observed virological suppression, persistence and injection-schedule adherence in selected PWH aged ≥ 60 years. Age ≥ 60 showed no clear independent association with definitive discontinuation. Comorbidity burden may inform closer follow-up, although this exploratory finding requires confirmation. Evidence remains limited in those aged ≥ 70 years. ClinicalTrials.gov, NCT07703748.

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Journal
Aging Clinical and Experimental Research
Published
2026-11-07
DOI
https://doi.org/10.1007/s40520-026-03562-6
Primary Topic
HIV/AIDS drug development and treatment
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article
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article

Long-acting cabotegravir plus rilpivirine in people with HIV aged ≥ 60 years: persistence, virological outcomes, and comorbidity burden in the spanish RELATIVITY Cohort

Reinaldo Martinez, Antonia Alcaraz, Luís Buzón, Juan Manuel Tiraboschi et al.
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Aging Clinical and Experimental Research
HIV/AIDS drug development and treatment
article

Long-acting cabotegravir plus rilpivirine in people with HIV aged ≥ 60 years: persistence, virological outcomes, and comorbidity burden in the spanish RELATIVITY Cohort

Reinaldo Martinez, Antonia Alcaraz, Luís Buzón, Juan Manuel Tiraboschi, Francisco Javier Fanjul, Jesús Troya, Noemí Cabello‐Clotet, María Lagarde, María José Crusells, Carmen Hidalgo-Tenorio, Miguel Torralba, Laura M. Gisbert, María José Galindo, Eva María Ferreira, Sara García, Alberto Romero, C. Busca, María Remedios Alemán, José Sanz, Luis Enrique Morano, Adrián Rodriguez, Inmaculada Poquet-Catalá, Paula Runza, Patricia Noemí Barragán, Marta Millán
article en

Abstract

Evidence on long-acting cabotegravir plus rilpivirine (CAB + RPV LA) in older people with HIV (PWH) remains limited. We evaluated virological outcomes, treatment persistence and injection-schedule adherence by age. This nationwide ambispective RELATIVITY cohort analysis compared virologically suppressed adults aged ≥ 60 and < 60 years who initiated CAB + RPV LA by 31 December 2024. Persistence was assessed using Kaplan–Meier estimates and multivariable Cox regression, including an exploratory age-by-comorbidity interaction. Among 3,349 participants at 53 centers, 407 (12.2%) were aged ≥ 60 years (median, 63.0; interquartile range, 61.0–66.8); 349 were aged 60–69, 54 aged 70–79 and four aged ≥ 80. Older participants had more comorbidities (median, 2 vs. 0), longer prior antiretroviral exposure (18 vs. 9 years) and median follow-up of 26.5 versus 25.1 months. Observed virological suppression was 97.3% versus 96.5%, virological failure 0.2% versus 0.9%, and definitive discontinuation 11.3% versus 11.0%. Age ≥ 60 was not clearly associated with discontinuation after adjustment (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.63–1.36). The exploratory age-by-comorbidity interaction HR was 1.34 (1.07–1.67); the older-group HR per comorbidity was 1.20 (0.99–1.46). Injection-schedule adherence ≥ 90% was observed in 99.5% versus 99.3%. CAB + RPV LA showed high observed virological suppression, persistence and injection-schedule adherence in selected PWH aged ≥ 60 years. Age ≥ 60 showed no clear independent association with definitive discontinuation. Comorbidity burden may inform closer follow-up, although this exploratory finding requires confirmation. Evidence remains limited in those aged ≥ 70 years. ClinicalTrials.gov, NCT07703748.

Aging Clinical and Experimental Research
Hospital Universitario de Canarias (ES), Hospital Universitario La Paz (ES), Bellvitge University Hospital (ES), University Hospital Complex Of Vigo (ES), Hospital Clínico San Carlos (ES), Hospital General De Segovia (ES), Hospital Son Llatzer (ES), Hospital General Universitario Morales Meseguer (ES), Hospital Universitario de Guadalajara (ES), Hospital Clínico Universitario de Valencia (ES), University Hospital Mútua de Terrassa (ES), Marqués de Valdecilla University Hospital (ES), Pius Hospital de Valls (ES), Hospital Universitario 12 De Octubre (ES), Hospital Universitario Príncipe de Asturias (ES), Hospital Universitario Miguel Servet (ES), Hospital Universitario de Burgos (ES), Hospital Universitario Virgen de las Nieves (ES), Hospital Santa Caterina (ES), Hospital Clínico Universitario Lozano Blesa (ES), Hospital Universitario Puerto Real (ES), Hospital Universitario Son Espases (ES), Hospital Universitario Infanta Leonor (ES)
Good health and well-being
Openalex Percentile: Top 14%
HIV/AIDS drug development and treatment
DOIOpen Access PDFOpenAlex
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