{ "abstract": "Background\n\nLong-acting injectable cabotegravir plus rilpivirine (CAB + RPV LA) is an established maintenance option for virologically suppressed people with human immunodeficiency virus-1 (HIV-1), but long-term real-world persistence and virological failure (VF) data remain limited.Methods\n\nRELATIVITY is an ongoing nationwide ambispective multicenter cohort of adults with HIV who switched from suppressive oral antiretroviral therapy to CAB + RPV LA in routine care in Spain. Data through 1 March 2026 were analyzed. The outcomes were virological suppression, treatment persistence, protocol-defined VF, and time to discontinuation-related events. Virological failure was defined as 2 consecutive HIV-1 RNA values ≥200 copies/mL or 1 value ≥500 copies/mL prompting discontinuation.Results\n\nAmong 3349 participants, 3343 had valid follow-up dates; the median follow-up was 25.1 months (19.3-30.8). Virological suppression was documented in 3197/3349 (95.5%) overall and 3197/3309 (96.6%) with an evaluable closest viral load; 40 (1.2%) lacked an evaluable value. Injection adherence was ≥90% in 3257/3280 (99.3%) evaluable participants. Overall, 2979/3349 (89.0%) remained on CAB + RPV LA. Virological failure occurred in 28/3349 (0.8%); 20/28 (71.4%) occurred within the first 12 months after switching. Emergent integrase strand transfer inhibitor and/or nonnucleoside reverse transcriptase inhibitor resistance was detected in 19/28 VF cases, and 24/28 achieved virological suppression after switching to oral therapy. Treatment-limiting injection-site reactions and systemic adverse events occurred in 2.4% and 1.6%, respectively.Conclusions\n\nLong-acting injectable cabotegravir plus rilpivirine showed high virological suppression and persistence beyond 2 years in routine care. Virological failure was uncommon and clustered mainly within 12 months, supporting early virological monitoring and prompt resistance-guided management.", "abstract_shown": true, "affiliations": [ "Infectious Diseases Division, Hospital Universitario de Burgos, Burgos, Spain.", "Infectious Diseases Division, Hospital Universitario Clínico San Carlos, Madrid, Spain.", "Infectious Diseases Division, HIV Unit, Hospital Universitario La Paz, Madrid, Spain.", "Infectious Diseases Division, Hospital Clínico Universitario de Valencia, Valencia, Spain.", "Infectious Diseases Division, Hospital Universitario Miguel Servet, Zaragoza, Spain.", "Infectious Diseases Division, HIV Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.", "Infectious Diseases Division, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.", "Infectious Diseases Division, Internal Medicine, Hospital Universitario de Guadalajara, Guadalajara, Spain.", "Infectious Diseases Division, Hospital Universitari Son Espases, Palma de Mallorca, Spain.", "Infectious Diseases Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.", "Instituto de Investigación Sanitaria de les Illes Balears, Hospital Universitario Son Llátzer, Palma de Mallorca, Spain.", "Infectious Diseases Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.", "Infectious Diseases Department, Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain.", "Infectious Diseases Division, Internal Medicine, Hospital Universitario La Princesa, Madrid, Spain.", "Infectious Diseases Division, Hospital Universitario Virgen de las Nieves, Granada, Spain.", "Infectious Diseases Division, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain.", "Infectious Diseases Division, Hospital Universitario Clínico San Cecilio, Granada, Spain.", "Infectious Diseases Division, Hospital General Universitario Reina Sofía, Murcia, Spain.", "Infectious Diseases Division, Hospital de Dénia-Marina Salud, Alicante, Spain.", "Infectious Diseases Division, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.", "Infectious Diseases Department, Hospital Universitario de Bellvitge, Barcelona, Spain.", "Internal Medicine, Hospital Universitario de Torrejón, Madrid, Spain.", "Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.", "Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.", "Infectious Diseases Division, Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain.", "Infectious Diseases Division, Hospital Universitario San Agustín, Avilés, Spain.", "Infectious Diseases Department, HIV Unit, Hospital Universitari Mútua Terrassa, Terrassa, Spain.", "Infectious Diseases Division, Hospital Universitario de Puerto Real, Puerto Real, Cádiz, Spain.", "Infectious Diseases Division, Hospital Universitario Central de Asturias, Oviedo, Spain.", "Infectious Diseases Division, Internal Medicine, Hospital Universitario de Cabueñes, Gijón, Spain.", "Infectious Diseases Division, Hospitalario Universitario de Toledo, Toledo, Spain.", "Infectious Diseases Division, Hospital General Universitario Morales Meseguer, Murcia, Spain.", "Infectious Diseases Division, Hospital Verge de la Cinta, Tortosa, Spain.", "Internal Medicine, Complejo Asistencial de Segovia, Segovia, Spain.", "Infectious Diseases Division, Internal Medicine, Hospital Universitario Río Hortega, Valladolid, Spain.", "Internal Medicine, Hospital de Viladecans, Viladecans, Spain.", "Infectious Diseases Division, Hospital Comarcal de la Vega Baja, Alicante, Spain.", "Infectious Diseases Division, Hospital de Santa Caterina de Salt, Girona, Spain.", "Internal Medicine, Hospital Universitario Doctor José Molina Orosa, Las Palmas, Spain.", "Infectious Diseases Department, Hospital Universitario Fundación de Alcorcón, Alcorcón, Spain." ], "article_type": "research article", "arxiv": null, "author_total": 52, "authors": [ { "affs": [ 0 ], "name": "Luis Buzón", "orcid": "0000-0003-4847-8014" }, { "affs": [ 1 ], "name": "Noemí Cabello-Clotet", "orcid": "0000-0001-7259-554X" }, { "affs": [ 2 ], "name": "María Luisa Montes", "orcid": "0000-0003-1748-813X" }, { "affs": [ 3 ], "name": "María José Galindo", "orcid": "0000-0002-4911-4071" }, { "affs": [ 4 ], "name": "Rosa María Martínez" }, { "affs": [ 5 ], "name": "Mireia Santacreu" }, { "affs": [ 6 ], "name": "María Remedios-Alemán" }, { "affs": [ 7 ], "name": "Miguel Torralba", "orcid": "0000-0003-2166-7405" }, { "affs": [ 8 ], "name": "Francisco Fanjul", "orcid": "0000-0003-1852-0330" }, { "affs": [ 9 ], "name": "Manuel Gutiérrez-Cuadra" }, { "affs": [ 10 ], "name": "Adrián Rodríguez" }, { "affs": [ 11 ], "name": "María José Crusells", "orcid": "0000-0002-2697-6592" }, { "affs": [ 12 ], "name": "María Navarro" }, { "affs": [ 13 ], "name": "María Aguilera-García" }, { "affs": [ 14 ], "name": "Carmen Hidalgo-Tenorio" }, { "affs": [ 15 ], "name": "Luis Enrique Morano", "orcid": "0000-0002-0560-3260" }, { "affs": [ 16 ], "name": "David Vinuesa" }, { "affs": [ 17 ], "name": "Enrique Bernal-Morell" }, { "affs": [ 18 ], "name": "Carlos de Andrés", "orcid": "0000-0002-3796-8934" }, { "affs": [ 19 ], "name": "Hadrián Pernas", "orcid": "0000-0001-9489-9130" }, { "affs": [ 20 ], "name": "Juan Tiraboschi", "orcid": "0000-0002-0073-873X" }, { "affs": [ 21 ], "name": "Alejandro Bendala", "orcid": "0000-0002-7705-2656" }, { "affs": [ 22 ], "name": "María Jesús Vivancos", "orcid": "0000-0002-9373-6011" }, { "affs": [ 23 ], "name": "Cristina Díez", "orcid": "0000-0002-3508-9979" }, { "affs": [ 24 ], "name": "Guillermo Soria", "orcid": "0009-0002-9069-9777" }, { "affs": [ 25 ], "name": "Desiré Pérez" }, { "affs": [ 26 ], "name": "Mireia Cairó" }, { "affs": [ 27 ], "name": "Alberto Romero" }, { "affs": [ 28 ], "name": "Rebeca Cabo" }, { "affs": [ 29 ], "name": "Josefa Soler" }, { "affs": [ 30 ], "name": "María Antonia Sepúlveda" }, { "affs": [ 31 ], "name": "Joaquín Bravo", "orcid": "0000-0003-2079-0305" }, { "affs": [ 32 ], "name": "Cristina Escrich" }, { "affs": [ 33 ], "name": "Eva Ferreira" }, { "affs": [ 34 ], "name": "Beatriz Valentín" }, { "affs": [ 35 ], "name": "Magdalena Muelas", "orcid": "0000-0002-4342-4191" }, { "affs": [ 36 ], "name": "Ana Lucas-Dato" }, { "affs": [ 37 ], "name": "Albert Gómez", "orcid": "0009-0008-8910-0062" }, { "affs": [ 38 ], "name": "Ana Cerezales" }, { "affs": [ 39 ], "name": "Juan Emilio Losa", "orcid": "0000-0002-0750-0185" }, { "name": "José Sanz", "orcid": "0000-0003-3180-184X" }, { "name": "Mar Masía" }, { "name": "Juan José Corte-García" }, { "name": "Ana Antolí" }, { "name": "Juan Carlos Gainzarain", "orcid": "0009-0000-0279-2281" }, { "name": "Miriam Estébanez" }, { "name": "Patricia Barragán" }, { "name": "Marta Clavero" }, { "name": "Óscar Ferrero", "orcid": "0000-0003-2754-3788" }, { "name": "Jesús Troya", "orcid": "0000-0001-7323-114X" }, { "name": "RELATIVITY Cohort" }, { "name": "RELATIVITY Cohort" } ], "bibtex": "https://research.draconitic.com/paper/4h7qfzgma6cfg.bib", "cited_by": 0, "doi": "10.1093/ofid/ofag622", "fulltext_url": "https://europepmc.org/articles/PMC13683463", "id": "4h7qfzgma6cfg", "issns": [ "2328-8957" ], "landing_url": "https://europepmc.org/article/MED/42908902", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2725|HIV/AIDS drug development and treatment" ] ], "openalex": "W7223112614", "pdf_url": "https://europepmc.org/articles/PMC13683463?pdf=render", "pmcid": "PMC13683463", "pmid": "42908902", "published": "2026-10-21", "publisher": null, "ris": "https://research.draconitic.com/paper/4h7qfzgma6cfg.ris", "sources": [ { "first_seen": "2026-10-30T12:20:10Z", "native_id": "MED:42908902", "source": "europepmc", "url": "https://europepmc.org/article/MED/42908902" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2725|HIV/AIDS drug development and treatment", "subfield": "infectious-disease" } ], "title": "Long-term Effectiveness, Treatment Persistence, and Timing of Virological Failure With Long-Acting Cabotegravir Plus Rilpivirine in Real-World HIV Care: RELATIVITY Cohort.", "title_text": "Long-term Effectiveness, Treatment Persistence, and Timing of Virological Failure With Long-Acting Cabotegravir Plus Rilpivirine in Real-World HIV Care: RELATIVITY Cohort.", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:10Z", "url": "https://research.draconitic.com/paper/4h7qfzgma6cfg", "venue": "Open forum infectious diseases", "versions": [] }