EACS2023: 254 Uptake and discontinuation of the long-acting duo in the Swiss HIV Cohort Study: preliminary analysis on cabotegravir plus rilpivirine J.J. Duran Ramirez , K. Kusejko , K.J. Metzner , M. Huber , Y. Martin , M. Stöckle , A. Calmy , L.A. Decosterd , M. Cavassini , E. Bernasconi , P. Schmid , H.F. Günthard , D.L. Braun , Swiss HIV Cohort Study University Hospital Zurich, Department of Infectious Diseases and Hospital Epidemiology, Zurich, Switzerland, University of Zurich, Institute of Medical Virology, Zurich, Switzerland, Bern University Hospital, University of Bern, Department of Infectious Diseases, Bern, Switzerland, University Hospital Basel, University of Basel, Division of Infectious Diseases & Hospital Epidemiology, Basel, Switzerland, University Hospital Geneva, University of Geneva, Department of Infectious Diseases, Geneva, Switzerland, Lausanne University Hospital, University of Lausanne, Department of Infectious Diseases, Lausanne, Switzerland, Ente Ospedaliero Cantonale, University of Geneva and University of Southern Switzerland, Department of Infectious Diseases, Lugano, Switzerland, Cantonal Hospital St Gallen, Division of Infectious Diseases, St Gallen, Switzerland General data Abstract category: Antiretroviral therapy – observational studies Abstract body Purpose: Routine clinical data on the uptake and discontinuation of cabotegravir plus rilpivirine long-acting (CAB+RPV-LA) is scarce. We present data from the Swiss HIV Cohort Study (SHCS) more than one year after market authorization (March 2022) in Switzerland. Method: We assessed sociodemographic, clinical, and behavioural baseline characteristics of all SHCS participants initiating the CAB+RPV LA regimen since March 2022. Moreover, we describe reasons for CAB+RPV-LA discontinuation. Results: From 9,479 active SHCS participants, 264 (2.8%) initiated CAB+RPV-LA, with a peak of 35 participants starting in June 2022 (Figure). The median age was 48 years, and the median body mass index was 25.4 kg/m2 (Table). The majority of individuals were male (n=216;82%), of white ethnicity (n=186;71%), acquired HIV through men-who-have-sex-with-men (MSM) sexual contacts (n=169;64%), had higher education (n=134;51%), were in a steady partnership (n=156;61%) and highly adherent (n=207;81%) to the previous antiretroviral therapy (ART) regimen. Albeit 59% (n=156) of participants were recruited in larger university hospitals, recruitment also took place in private practices (n=73;28%) and affiliated hospitals (n=35;13%). 29% (77/264) had prior exposure to RPV, and most participants switched from bictegravir/ emtricitabin/ tenofovir alafenamide (n=77;29%) to CAB+RPV-LA. Eight individuals (3%) discontinued the CAB+RPV-LA regimen: reasons for discontinuation were participant's wish (n=1), death (n=1), injection site reactions (n=2), moving to a foreign country without access (n=1), loss to SHCS care (n=1), confirmed virological failure (n=1, two consecutive measurements of >50 RNA copies/mL plasma), and low RPV blood concentration (n=1). Table 1. Baseline characteristics of participants on CAB+RPV-LA regimen Variable Total, N = 264 Median [interquartile range] or Frequency (%) Age, years 48 [41, 54] Female, sex assigned at birth 48 (18%) Mode of HIV acquisition Men who have sex with men 169 (64%) Heterosexuals 73 (28%) People who inject drugs 9 (3.4%) Ethnicity White 186 (71%) Black or African American 47 (18%) Hispano-American 17 (6.5%) Asian 10 (3.8%) Health care provider Larger university hospitals 156 (59%) Private practices 73 (28%) Affiliated hospitals 35 (13%) University degree or other higher education 134 (51%) Steady partnership 156 (61%) CD4 count, cells/µL 739.00 [546.75, 920.25] CD4 nadir, cells/µL 306.50 [184.50, 462.00] Time on ART, years 10.00 [6.00, 16.00] Five most frequent previous ART regimens Bictegravir / Emtricitabin / Tenofovir Alafenamide 77 (29%) Dolutegravir / Lamivudin 40 (15%) Emtricitabine / Rilpivirine / Tenofovir Alafenamide 31 (12%) Dolutegravir / Abacavir / Lamivudin 26 (9.9%) Emtricitabin / Tenofovir Alafenamide/ Elvitegravir / Cobicistat 22 (8.4%) Prior exposure with RPV 77 (29%) Body mass index, kg/m2 25.43 [23.35, 28.40] Two most frequent HIV subtypes B 110 (69%) A (not A6/A1) 10 (6.3%) Imperfect previous ART adherence 45 (17.3%) Conclusions: After more than one year of market authorization, only a small proportion of SHCS participants switched to the CAB+RPV-LA regimen, and most of them were middle-aged white MSM with high educational levels. The vast majority of participants switched from an integrase strand transfer inhibitor-based regimen, with a high proportion having prior exposure to RPV. CAB+RPV-LA discontinuation and confirmed virological failure (0.4 %) were low. 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 1,2 1,2 2 3 4 5 6 6 7 8 1,2 1 1 2 3 4 5 6 7 8 92 19TH EUROPEAN AIDS CONFERENCE | WARSAW 2023
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