Use of Long-Acting Cabotegravir/Rilpivirine in PWH With or Without Initial Viremia

Long-acting cabotegravir/rilpivirine (LA-CAB/RPV) was approved by the FDA in 2021 for people with HIV (PWH) who attained virologic suppression on oral antiretroviral therapy (ART), but this strategy is not currently approved for PWH unable to achieve virologic suppression with oral ART. In an observational study of PWH who started LA-CAB/RPV, investigators in San Francisco assessed virologic suppression at 48 weeks among 241 persons without viremia at treatment initiation versus 129 with viremia (overall median age, 44; 80% cisgender men; 23% Black; 40% with housing instability; 46% with reported substance use).

Among those who started LA-CAB/RPV with viremia, median viral load was 45,600 copies/mL and half had CD4 counts <200 cells/mm³. Ind…