Immune Trajectories After Switch to Long-Acting Cabotegravir Plus Rilpivirine in the RELATIVITY Cohort.
24 affiliations
- 1Hospital Universitario Infanta Leonor, Madrid, Spain.
- 2Hospital Universitario Clínico San Carlos, Madrid, Spain.
- 3Hospital Universitario La Paz, Madrid, Spain.
- 4Hospital Clínico Universitario de Valencia, Valencia, Spain.
- 5Hospital Universitario Miguel Servet, Zaragoza, Spain.
- 6Hospital Universitario 12 de Octubre, Madrid, Spain.
- 7Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
- 8Hospital Universitario de Guadalajara, Guadalajara, Spain.
- 9Hospital Universitari Son Espases, Palma de Mallorca, Spain.
- 10Hospital Universitario Marqués de Valdecilla, Santander, Spain.
- 11Hospital Universitario Son Llatzer, Palma de Mallorca, Spain.
- 12Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
- 13Consorci Corporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain.
- 14Medicina Interna. Hospital Universitario La Princesa, Madrid, Spain.
- 15Hospital Universitario Virgen de las Nieves, Granada, Spain.
- 16Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- 17Hospital Universitario Clínico San Cecilio, Granada, Spain.
- 18Hospital General Universitario Reina Sofía, Murcia, Spain.
- 19Hospital Universitario de Denia-Marina Salud, Alicante, Spain.
- 20Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.
- 21Hospital Universitario de Bellvitge, Barcelona, Spain.
- 22Hospital Universitario de Torrejón, Madrid, Spain.
- 23Hospital Universitario Ramón y Cajal, Madrid, Spain.
- 24Hospital Universitario de Burgos, Burgos, Spain.
Abstract
Background
Immune and virological trajectories after switching to long-acting cabotegravir plus rilpivirine (CAB+RPV LA) remain incompletely characterized in routine care settings.Methods
We 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
Among 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
During 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.
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BibTeX
@article{troya2026immune,
title = {{Immune Trajectories After Switch to Long-Acting Cabotegravir Plus Rilpivirine in the RELATIVITY Cohort.}},
author = {Jesús Troya and Noemí Cabello-Clotet and José Ignacio Bernardino and María José Galindo and Rosa María Martínez and Juan Martín and María Remedios Alemán and Miguel Torralba and Francisco Fanjul and María Carmen Fariñas and Adrián Rodríguez and María José Crusells and Sonia Calzado and Javier Pérez-Serrano and Carmen Hidalgo-Tenorio and Luis Enrique Morano and David Vinuesa and Enrique Bernal-Morell and Inmaculada Poquet-Catalá and Hadrián Pernas-Pardavila and Juan Tiraboschi and Diana Corps and María Jesús Vivancos and Luis Buzón-Martín and RELATIVITY Cohort and RELATIVITY Cohort},
journal = {Open forum infectious diseases},
year = {2026},
month = oct,
doi = {10.1093/ofid/ofag583},
url = {https://europepmc.org/article/MED/42921238},
note = {CC BY},
}
RIS
TY - JOUR
TI - Immune Trajectories After Switch to Long-Acting Cabotegravir Plus Rilpivirine in the RELATIVITY Cohort.
AU - Jesús Troya
AU - Noemí Cabello-Clotet
AU - José Ignacio Bernardino
AU - María José Galindo
AU - Rosa María Martínez
AU - Juan Martín
AU - María Remedios Alemán
AU - Miguel Torralba
AU - Francisco Fanjul
AU - María Carmen Fariñas
AU - Adrián Rodríguez
AU - María José Crusells
AU - Sonia Calzado
AU - Javier Pérez-Serrano
AU - Carmen Hidalgo-Tenorio
AU - Luis Enrique Morano
AU - David Vinuesa
AU - Enrique Bernal-Morell
AU - Inmaculada Poquet-Catalá
AU - Hadrián Pernas-Pardavila
AU - Juan Tiraboschi
AU - Diana Corps
AU - María Jesús Vivancos
AU - Luis Buzón-Martín
AU - RELATIVITY Cohort
AU - RELATIVITY Cohort
PY - 2026
DA - 2026/10/23
JO - Open forum infectious diseases
DO - 10.1093/ofid/ofag583
UR - https://europepmc.org/article/MED/42921238
AB - Background Immune and virological trajectories after switching to long-acting cabotegravir plus rilpivirine (CAB+RPV LA) remain incompletely characterized in routine care settings.Methods We 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 Among 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 During 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.
SN - 2328-8957
ER -