Low cabotegravir trough concentrations without oral lead-in in patients with HIV-1 switching to long-acting cabotegravir and rilpivirine

In a cohort of 72 consecutive virologically-suppressed patients with HIV-1 switching to long-acting cabotegravir and rilpivirine, we observed low cabotegravir trough concentrations 1 and 3 months after the first injection, with a significant association with no oral lead-in at 1 month odds ratio (OR) = 6.3 [95% confidence interval (CI) 1.7–29.5, P = 0.01] and three months (OR = 5.6 95% CI 1.3–29.7, P = 0.03), and with high BMI at 1 month (OR = 1.3 95% CI 1.1–1.6, P = 0.007).