What question did this study set out to answer?

To describe the virological outcomes of people with HIV after discontinuing long-acting cabotegravir and rilpivirine therapy.

April 18, 2026Open Access

Virological outcomes of PWH who discontinued cabotegravir/rilpivirine long-acting therapy in a real-world context

Key Points

To describe the virological outcomes of people with HIV after discontinuing long-acting cabotegravir and rilpivirine therapy.
Included individuals from the Icona Cohort who discontinued long-acting CAB/RPV.
Focused on those with at least one follow-up appointment after discontinuation.
Monitored the return to oral antiretroviral therapy (ART) and their virological status afterwards.
10.4% of participants discontinued CAB/RPV, primarily due to toxicity or adverse events.
72.6% resumed the same oral ART regimen they were on before switching to LA therapy.
19.9% had a cumulative probability of discontinuing oral ART after CAB/RPV over 12 months.
All but one participant maintained or achieved HIV RNA levels below 50 copies/mL after resuming oral ART.

Abstract

Abstract The aim of this study was to describe virological outcomes in people with HIV (PWH) after discontinuation of long-acting (LA) cabotegravir (CAB) plus rilpivirine (RPV). All PWH enrolled in the Icona Cohort who discontinued CAB/RPV LA and had at least one follow-up after discontinuation were included. A total of 84 out of 805 (10.4%) PWH discontinued CAB/RPV, mainly due to toxicity or adverse events (67.9%). Most individuals (72.6%) returned to the same oral antiretroviral regimen used prior LA therapy. The 12-month cumulative probability of discontinuing oral ART after CAB/RPV was 19.9% (95% confidence interval CI 11.9-32.2%). After switching back to oral ART all individuals except one maintained or achieved HIV RNA levels below 50 copies/mL. These findings suggest that PWH who discontinue LA CAB/RPV and resume oral ART maintain or achieve high rates of virologic suppression.

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