Research Summary

Real-World Outcomes Support Use of CAB+RPV LA in Virologically Suppressed Women with HIV

Kate Young

In a real-world observational study of virologically suppressed women living with HIV, the long-acting injectable combination of cabotegravir and rilpivirine (CAB+RPV LA) demonstrated strong clinical durability and virologic control, with low rates of confirmed virologic failure (CVF). Findings from the OPERA cohort were presented at the Conference on Retroviruses and Opportunistic Infections 2025 in San Francisco, CA, offering clinically relevant data for physicians managing HIV in women.

The study evaluated 415 women aged 18 and older who were virologically suppressed (HIV-1 RNA < 50 copies/mL) at the time of initiating CAB+RPV LA between January 2021 and August 2023. Participants received either monthly (Q1M) or every-2-month (Q2M) injections. The cohort was demographically diverse: 64% identified as Black, 20% Hispanic, and 13% as transgender women. Nearly half (48%) had a BMI ≥ 30 kg/m², and the median age was 43 years, with a median HIV diagnosis duration of 9 years.

Among participants, 92% completed initiation (defined as receiving two injections ≤ 67 days apart), with 77% starting on a Q2M schedule. Median follow-up was 12.4 months. At study conclusion, 78% remained on CAB+RPV LA therapy.

Of 340 women with a known dosing schedule and at least one maintenance injection, 43% received all injections on time. However, 37% experienced at least one delayed injection and 12% had at least one missed injection. Despite this variability in injection timing, virologic suppression remained high. Among the 372 women with at least one viral load measurement during follow-up, 94% were suppressed at their last viral load, and 82% maintained suppression throughout all assessments. CVF was rare, occurring in only 2% of participants (n = 7).

clinical outcomes in women receiving CAB+RPV LA

Median change in CD4 count over follow-up was modest, at +40 cells/μL (interquartile range, -91 to 152), suggesting stable immunologic status.

"A diverse population of women with HIV was able to receive CAB+RPV LA on-time and remain suppressed in this real-world study," the authors concluded.

Reference:
Smith I, et al. Clinical outcomes among virologically suppressed women receiving CAB+RPV LA in the OPERA Cohort. Paper Presented at: Conference on Retroviruses and Opportunistic Infections; March 9-12, 2025; San Francisco, CA. Accessed March 24, 2025.