Experience of treatment with long-acting injectable cabotegravir/rilpivirine (LA iCAB/RPV) in viremic young patients with perinatally acquired HIV with adherence challenges: A five-case series
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: Long-acting injectable antiretroviral therapy (ART) has transformed HIV care by reducing the burden of daily medication and improving adherence. While primarily approved for virologically suppressed individuals, emerging evidence supports its use in viremic patients with complex treatment histories. However, real-world evidence remains limited, especially in youth with perinatally acquired HIV. This case series provides further insights into the use of long-acting ART in this group. PATIENTS AND METHODS: This case series presents five young adults (aged 20-31) with perinatally acquired HIV (PHIV) and long-term ART failure, followed at Hôtel-Dieu University Hospital in Paris. All were transitioned to long-acting intramuscular cabotegravir and rilpivirine (LA iCAB/RPV); one also received a single injection of lenacapavir at initiation. RESULTS: Patients had been on ART for a mean of 20 years and exposed to an average of seven prior regimens. Most had experienced HIV-related complications, and four showed resistance mutations to existing treatments. Despite baseline viremia and complex treatment histories, four of five achieved virologic suppression (<1.3 log RNA copies/ml) within 3 months of initiating LA iCAB/RPV and one patient within 9 months. One patient later experienced a modest viral rebound (1.8 log copies/ml) after 14 months of control. Two patients missed scheduled injections but were successfully reinduced using the loading dose protocol. Treatment was well tolerated, with no adverse events. CONCLUSIONS: LA iCAB/RPV appears to be a promising treatment strategy for youth with perinatally acquired HIV facing persistent adherence barriers and previous treatment failures. Further studies with larger cohorts and extended follow-up are needed to confirm these results and inform care strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".