{ "abstract": "Background\n\nImmune and virological trajectories after switching to long-acting cabotegravir plus rilpivirine (CAB+RPV LA) remain incompletely characterized in routine care settings.Methods\n\nWe analyzed virologically suppressed adults switching to CAB+RPV LA in the Spanish multicenter RELATIVITY cohort. Paired CD4+, CD8+, and CD4/CD8 measurements were assessed at approximately 12 and 24 months and at the last available immune assessment. Analyses used a 1.0 ratio threshold and incorporated longitudinal HIV-1 RNA, recorded geographic origin, pre-switch suppression duration, and immediate pre-switch antiretroviral therapy.Results\n\nAmong 3349 participants, the last paired-ratio assessment (n = 2929) occurred at a median of 22 months (IQR, 16-27). Median changes were -7 cells/mm³ (IQR, -138 to +117; n = 2992) for CD4+ T-cell count, -60 cells/mm³ (IQR, -214 to +75; n = 2941; P < .001) for CD8+ T-cell count, and +0.07 (IQR, -0.05 to +0.20; n = 2929; P < .001) for the CD4/CD8 ratio. Baseline CD4/CD8 <1.0 was independently associated with greater ratio increase (adjusted beta, +0.060; 95% CI, +.030 to +.090; P < .001). Longer pre-switch suppression and any post-switch HIV-1 RNA ≥50 copies/mL were associated with smaller ratio increases. Adjudicated virological failure occurred in 28/3349 (0.8%). Findings persisted among participants with all recorded post-switch HIV-1 RNA values <50 copies/mL and after excluding protocol-defined virological failure.Conclusions\n\nDuring effective CAB+RPV LA maintenance, CD4+ T-cell counts showed no meaningful change, while a modest decline in CD8+ T-cell counts was accompanied by a small CD4/CD8 ratio increase. These descriptive changes are compatible with continued immune evolution during sustained suppression and do not establish a CAB+RPV-specific effect or justify additional routine T-cell-subset monitoring.", "abstract_shown": true, "affiliations": [ "Hospital Universitario Infanta Leonor, Madrid, Spain.", "Hospital Universitario Clínico San Carlos, Madrid, Spain.", "Hospital Universitario La Paz, Madrid, Spain.", "Hospital Clínico Universitario de Valencia, Valencia, Spain.", "Hospital Universitario Miguel Servet, Zaragoza, Spain.", "Hospital Universitario 12 de Octubre, Madrid, Spain.", "Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.", "Hospital Universitario de Guadalajara, Guadalajara, Spain.", "Hospital Universitari Son Espases, Palma de Mallorca, Spain.", "Hospital Universitario Marqués de Valdecilla, Santander, Spain.", "Hospital Universitario Son Llatzer, Palma de Mallorca, Spain.", "Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.", "Consorci Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain.", "Medicina Interna. Hospital Universitario La Princesa, Madrid, Spain.", "Hospital Universitario Virgen de las Nieves, Granada, Spain.", "Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain.", "Hospital Universitario Clínico San Cecilio, Granada, Spain.", "Hospital General Universitario Reina Sofía, Murcia, Spain.", "Hospital Universitario de Denia-Marina Salud, Alicante, Spain.", "Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.", "Hospital Universitario de Bellvitge, Barcelona, Spain.", "Hospital Universitario de Torrejón, Madrid, Spain.", "Hospital Universitario Ramón y Cajal, Madrid, Spain.", "Hospital Universitario de Burgos, Burgos, Spain." ], "article_type": "research article", "arxiv": null, "author_total": 26, "authors": [ { "affs": [ 0 ], "name": "Jesús Troya", "orcid": "0000-0001-7323-114X" }, { "affs": [ 1 ], "name": "Noemí Cabello-Clotet", "orcid": "0000-0001-7259-554X" }, { "affs": [ 2 ], "name": "José Ignacio Bernardino", "orcid": "0000-0003-3501-8529" }, { "affs": [ 3 ], "name": "María José Galindo", "orcid": "0000-0002-4911-4071" }, { "affs": [ 4 ], "name": "Rosa María Martínez" }, { "affs": [ 5 ], "name": "Juan Martín", "orcid": "0000-0002-9783-1147" }, { "affs": [ 6 ], "name": "María Remedios Alemán" }, { "affs": [ 7 ], "name": "Miguel Torralba" }, { "affs": [ 8 ], "name": "Francisco Fanjul", "orcid": "0000-0003-1852-0330" }, { "affs": [ 9 ], "name": "María Carmen Fariñas", "orcid": "0000-0002-9259-2730" }, { "affs": [ 10 ], "name": "Adrián Rodríguez" }, { "affs": [ 11 ], "name": "María José Crusells", "orcid": "0000-0002-2697-6592" }, { "affs": [ 12 ], "name": "Sonia Calzado" }, { "affs": [ 13 ], "name": "Javier Pérez-Serrano", "orcid": "0000-0002-4699-4157" }, { "affs": [ 14 ], "name": "Carmen Hidalgo-Tenorio", "orcid": "0000-0002-6394-5728" }, { "affs": [ 15 ], "name": "Luis Enrique Morano", "orcid": "0000-0002-0560-3260" }, { "affs": [ 16 ], "name": "David Vinuesa", "orcid": "0000-0002-5663-8447" }, { "affs": [ 17 ], "name": "Enrique Bernal-Morell", "orcid": "0000-0002-4041-0579" }, { "affs": [ 18 ], "name": "Inmaculada Poquet-Catalá" }, { "affs": [ 19 ], "name": "Hadrián Pernas-Pardavila", "orcid": "0000-0001-9489-9130" }, { "affs": [ 20 ], "name": "Juan Tiraboschi", "orcid": "0000-0002-0073-873X" }, { "affs": [ 21 ], "name": "Diana Corps" }, { "affs": [ 22 ], "name": "María Jesús Vivancos", "orcid": "0000-0002-9373-6011" }, { "affs": [ 23 ], "name": "Luis Buzón-Martín", "orcid": "0000-0003-4847-8014" }, { "name": "RELATIVITY Cohort" }, { "name": "RELATIVITY Cohort" } ], "bibtex": "https://research.draconitic.com/paper/92rdc9hf6ne0j.bib", "cited_by": 0, "doi": "10.1093/ofid/ofag583", "fulltext_url": "https://europepmc.org/articles/PMC13693702", "id": "92rdc9hf6ne0j", "issns": [ "2328-8957" ], "landing_url": "https://europepmc.org/article/MED/42921238", "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", "2406|HIV Research and Treatment" ] ], "openalex": "W7223340735", "pdf_url": "https://europepmc.org/articles/PMC13693702?pdf=render", "pmcid": "PMC13693702", "pmid": "42921238", "published": "2026-10-23", "publisher": null, "ris": "https://research.draconitic.com/paper/92rdc9hf6ne0j.ris", "sources": [ { "first_seen": "2026-10-30T12:20:33Z", "native_id": "MED:42921238", "source": "europepmc", "url": "https://europepmc.org/article/MED/42921238" } ], "subjects": [ { "field": "biology", "origin": "openalex:2406|HIV Research and Treatment", "subfield": "microbiology" } ], "title": "Immune Trajectories After Switch to Long-Acting Cabotegravir Plus Rilpivirine in the RELATIVITY Cohort.", "title_text": "Immune Trajectories After Switch to Long-Acting Cabotegravir Plus Rilpivirine in the RELATIVITY Cohort.", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:33Z", "url": "https://research.draconitic.com/paper/92rdc9hf6ne0j", "venue": "Open forum infectious diseases", "versions": [] }