Efficacy, Safety and Retention in Care Among Adolescents and Youth With HIV on Long-Acting Injectable Cabotegravir/Rilpivirine Treatment: Real-World Observational Cohort Outcomes.

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Tierra Williams, Justin Unternaher, Wei Li Adeline Koay, Lorato Anderson, Kimberly Bright, Joanna Mareuil, Natella Rakhmanina
{"title":"Efficacy, Safety and Retention in Care Among Adolescents and Youth With HIV on Long-Acting Injectable Cabotegravir/Rilpivirine Treatment: Real-World Observational Cohort Outcomes.","authors":"Tierra Williams, Justin Unternaher, Wei Li Adeline Koay, Lorato Anderson, Kimberly Bright, Joanna Mareuil, Natella Rakhmanina","doi":"10.1097/INF.0000000000004742","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) can improve adherence among adolescents and youth with HIV (AYHIV). We evaluated LAI CAB/RPV treatment outcomes among AYHIV.</p><p><strong>Methods: </strong>An observational cohort study of AYHIV <25 years initiated LAI CAB/RPV from October 2021 to June 2024 as a standard of care. Descriptive data included demographics (age, race/ethnicity and gender/sexual orientation), body mass index, HIV history, efficacy (CD4, HIV RNA and resistance), safety and retention in care.</p><p><strong>Results: </strong>Twenty-five AYHIV (48% cisgender females; median age, 19 years; 64% with perinatally acquired HIV; median body mass index = 25.3 kg/m2; 52% virally suppressed for ≥6 months) received LAI CAB/RPV for a median duration of 11.8 (range, 0.8-31.3) months. Majority (n=24; 96%) initiated monthly LAI CAB/RPV injections, and 19 AYHIV (76%) switched to bimonthly injections. Seven AYHIV (28%) experienced transient viremia episodes (1-5/person; ranges, 48-1100 copies/mL) with most (78%) occurring within the initial 12 months, all episodes resolved at retesting after 3 to 91 days and none resulted in CAB and/or RPV resistance. Injection-associated pain/discomfort was mild to moderate and decreased over time. Grade 2 adverse events were self-resolved and included 3 AYHIV with postinjection adverse reactions and 1 AYHIV with QTc prolongation. Three cisgender female AYHIV became pregnant and continued LAI CAB/RPV. There were no discontinuations, missed or delayed injections. All AYHIV were virally suppressed at the end of the study follow-up.</p><p><strong>Conclusions: </strong>We report 100% engagement in care and viral suppression among 25 AYHIV on LAI CAB/RPV during study follow-up. More data are needed to evaluate the long-term outcomes and sustainability of LAI CAB/RPV treatment in AYHIV.</p>","PeriodicalId":19858,"journal":{"name":"Pediatric Infectious Disease Journal","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Infectious Disease Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/INF.0000000000004742","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) can improve adherence among adolescents and youth with HIV (AYHIV). We evaluated LAI CAB/RPV treatment outcomes among AYHIV.

Methods: An observational cohort study of AYHIV <25 years initiated LAI CAB/RPV from October 2021 to June 2024 as a standard of care. Descriptive data included demographics (age, race/ethnicity and gender/sexual orientation), body mass index, HIV history, efficacy (CD4, HIV RNA and resistance), safety and retention in care.

Results: Twenty-five AYHIV (48% cisgender females; median age, 19 years; 64% with perinatally acquired HIV; median body mass index = 25.3 kg/m2; 52% virally suppressed for ≥6 months) received LAI CAB/RPV for a median duration of 11.8 (range, 0.8-31.3) months. Majority (n=24; 96%) initiated monthly LAI CAB/RPV injections, and 19 AYHIV (76%) switched to bimonthly injections. Seven AYHIV (28%) experienced transient viremia episodes (1-5/person; ranges, 48-1100 copies/mL) with most (78%) occurring within the initial 12 months, all episodes resolved at retesting after 3 to 91 days and none resulted in CAB and/or RPV resistance. Injection-associated pain/discomfort was mild to moderate and decreased over time. Grade 2 adverse events were self-resolved and included 3 AYHIV with postinjection adverse reactions and 1 AYHIV with QTc prolongation. Three cisgender female AYHIV became pregnant and continued LAI CAB/RPV. There were no discontinuations, missed or delayed injections. All AYHIV were virally suppressed at the end of the study follow-up.

Conclusions: We report 100% engagement in care and viral suppression among 25 AYHIV on LAI CAB/RPV during study follow-up. More data are needed to evaluate the long-term outcomes and sustainability of LAI CAB/RPV treatment in AYHIV.

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信