EACS2023: 783 HIV viremias among patients who discontinued Cabotegravir (CAB)/Rilpivirine (RPV) Long acting (LA) intramuscular (IM) in real-life setting S. Seang , C. Palacios , N. Valin , A. Gansou , A. Faycal , J-P Vincensini , B. Abdi , S. Lambert-Niclot , G. Peytavin , C. Katlama , G. Pialoux , K. Lacombe , V. Pourcher , M-A Valantin Sorbonne University, Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France, COREVIH Ile-de-France Centre, Paris, France, Sorbonne University, Infectious Diseases Department, Tenon Hospital, AP-HP, Paris, France, Sorbonne University, Infectious Diseases Department, Saint- Antoine Hospital, AP-HP, Paris, France, Maison Medical Chemin Vert, Paris, France, Sorbonne University, Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Paris, France, Sorbonne University, Virology Department, Saint-Antoine Hospital, AP-HP, Paris, France, Bichat-Claude Bernard Hospital, AP-HP, INSERM UMR 1137 IAME, Pharmacological Department, Paris, France General data Abstract category: Antiretroviral therapy – observational studies Abstract body Purpose: To analyse the HIV viremia that led to CAB/RPV LAIM discontinuation in a real-world setting. Method: This cohort study enrolled PLHIV who started CAB/RPV LAIM between January,1 to December, 30 2022 in 3 French hospitals. Outcomes included (1)the rate and reasons of CAB/RPV LAIM discontinuation (including side effects, virological failure(VF) (2 consecutive pVLs >200cp/mL),low level replication (LLR)(2 consecutive pVLs 50-200cp/mL) over 12 months(M), (2)an analyse of HIV genotypic mutations, CAB/RPV plasma minimal concentrations(Cmin) at discontinuation and (3)M1 virological response after antiretroviral(ART) change. We present M12 preliminary analysis. Results: A total of 283 PLHIV (84% male, age 44 years old(37-54)) were switched to CAB/RPV LAIM (32 % with oral-leading phase (OLP)). At baseline, 97% had a pVL <50cp/mL. Fifteen patients(pts) (5%) had a body mass index (BMI)>30kg/m and HIV subtype A1/A6 accounted for 2 pts(0.8%). On June,1 2023 (11 months(8-13) follow up), 77(27%) patients reached M12 (all had pVL<50cp/mL) and 26 pts (9%) had discontinued CAB/RPV before M12 for reasons detailed in table 1. Among the 7 patients who discontinued CAB/RPV LAIM in a context of pVL>50cp/mL, half had unsuppressed viremia at baseline (2/3 had history of LLV)(table 2). At time of CAB/RPV discontinuation, 2/7 patients had VF (P1: 1500cp/mL/5469 cp/mL classified as a superinfection with a new HIV subtype B resistant to four ART classes; P2: 327 cp/mL/441cp/mL with adequate CAB and RPV concentrations) whereas the other 5 remained with LLV. CAB/RPV concentrations were adequate except in P3 (BMI 34kg/m2, baseline pVL 69cp/mL) where CAB/RPV Cmin were low both during OLP and injection phases leading to the emergence of INSTI resistance mutation (E138K). All other LLR patients (P4,P5,P6,P7) had a history of residual viremia and LLR remained after ART change. Conclusions: In this cohort, discontinuation of CAB/RPV LAIM for virological reason mainly occurred at low level viremia without emergence of drug-resistance associated mutations. General conditions 1. I confirm that I previewed this abstract and that all information is correct. I accept that the content of this abstract cannot be modified or corrected after the submission deadline and I am aware that it will be published exactly as submitted.: Yes 2. I confirm that the submission of the abstract constitutes my consent to publication (e.g. conference website, programmes, other promotions, etc.). : Yes 3. I herewith confirm that the contact details saved in this system are those of the corresponding author, who will be notified about the status of the abstract. The corresponding author is responsible for informing the other authors about the status of the abstract.: Yes 4. I agree that all data provided may be used (saved, stored, processed, transmitted and deleted) in compliance with the privacy policy to provide the services described.: Yes 1,2 3,2 4,2 4 1,2 5,2 6 7 8 1,2 3,2 4,2 1,2 1,2 1 2 3 4 5 6 7 8 st th 2 st 156 19TH EUROPEAN AIDS CONFERENCE | WARSAW 2023
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