SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Virologic Failure and Emergent Integrase Strand Transfer Inhibitor Drug Resistance With Long-Acting Cabotegravir for HIV Treatment: A Meta-analysis.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07620652 (Retrospective/Prospective Pilot Study to Evaluate Efficacy and Safety of Switching to BIC/FTC/TAF in PWH With a Previous Virological Failure Under CAB/RPV LAI), which is not on this map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Retrospective/Prospective Pilot Study to Evaluate Efficacy and Safety of Switching to BIC/FTC/TAF in PWH With a Previous Virological Failure Under CAB/RPV LAI
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Pooled it
- Cabotegravir and rilpivirine for treatment of HIV infection in Africa: week 96 results from the phase 3b randomized, open-label, noninferiority CARES trial.Nature medicine · 2026Trial
- Lenacapavir Plus Cabotegravir as Combination Treatment: Real-world Use Cases From the National Clinician Consultation Center.Open forum infectious diseases · 2025Trial
- Long-Acting Injectable Antiretroviral Therapies for HIV Treatment and Prevention: Clinical Pharmacology, Recent Advances and Future Opportunities.Journal of clinical pharmacology · 2026Review
- Antiretroviral resistance in at least second-line HIV-1 treatment virologic failure with common InSTI-based regimens.AIDS (London, England) · 2026Observational
- Extensive diversity and impact of drug-resistant HIV-1 variants in individuals with prior virologic failure.PLoS pathogens · 2026Article
- Effectiveness and Persistence of Long-Acting Injectable Cabotegravir and Rilpivirine in Migrant Individuals Living With HIV in Spain: Substudy of the RELATIVITY Cohort.Journal of the International AIDS Society · 2026Observational
- Genotyping not required for sustained effectiveness of long-acting cabotegravir plus rilpivirine: evidence from the RELATIVITY cohort.AIDS (London, England) · 2026Article
- The Epidemiology of HIV-1 Resistance to Two-Drug Regimens in Multicenter Cohort From Poland-A Cross-Sectional Study.Health science reports · 2026Article
- Clinical Consequences of Delaying Implementation of Long-Acting Antiretroviral Therapy for People With HIV and Persistent Viremia in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Ethical issues surrounding the implementation of long-acting injectable antiretroviral therapy in sub-Saharan Africa.International health · 2025Article
- Identifying care gaps along the HIV treatment failure cascade: A multistate analysis of viral load monitoring, re-suppression, and regimen switches in Zambia.PLoS medicine · 2025Article
- HIV-1 Drug Resistance Trends in the Era of Modern Antiretrovirals: 2018-2024.Open forum infectious diseases · 2025Article
- Treatment of Advanced HIV in the Modern Era.Drugs · 2025Review
- Assessment of Failures of Long-acting Cabotegravir and Rilpivirine in a Real-world Treatment Setting.Open forum infectious diseases · 2025Article
- HIV Viral Suppression With Unintentional Lenacapavir Monotherapy in Adherence-Challenged Patients: A Case Series.Open forum infectious diseases · 2025Article
- Extending follow-up visits in people with HIV (PWH) receiving bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) therapy: an expert opinion.Le infezioni in medicina · 2025Review
- Confronting Dual Therapeutic Hurdles in Advanced HIV: A Case Report on INSTIs Resistance and Talaromyces marneffei Coinfection.International medical case reports journal · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe long-acting injectable regimen of cabotegravir plus rilpivirine (CAB/RPV) emerged as an alternative to oral standard-of-care integrase strand transfer inhibitor (INSTI)-based regimens for individuals with adherence challenges or preference for reduced dosing schedules. Although oral INSTI regimens have a high barrier to emergent resistance, less is known about the potency and durability of CAB/RPV.
methodsWe reviewed clinical trial registries, PubMed, EMBASE, and conference abstract databases to identify reports of CAB/RPV for HIV therapy. We abstracted data on virologic failure (VF) and treatment-emergent INSTI resistance at 48 weeks (range: 24-52). We used single-proportion meta-analysis to summarize outcomes in 3 populations: antiretroviral therapy (ART)-naive individuals initiating CAB/RPV following suppression on oral ART, ART-experienced individuals switched to CAB/RPV with virologic suppression, and ART-experienced individuals switched to CAB/RPV with detectable viremia. Cochrane's RoB 2.0 and ROBINS-1 tools assessed risk of bias.
resultsThirty-three studies (N = 9224) reported VF prevalence. Nineteen studies (N = 5662) reported resistance data. VF prevalence was 1% (95% CI: 1%-3%) in induction-maintenance studies, 1% (1%-2%) in switch-suppressed studies, and 5% (3%-10%) in switch-viremic studies. INSTI resistance prevalence among successfully genotyped participants at failure was 71% (25%-95%), 61% (44%-75%), and 41% (20%-65%) respectively. Dolutegravir cross-resistance was common (64% of those with emergent resistance).
conclusionsAlthough VF rates with CAB/RPV were low, INSTI resistance emerged in approximately 40%-70% of individuals experiencing VF. These rates are significantly higher than those for oral INSTI-based regimens. Both individual-level and broader resistance surveillance may be warranted in populations with expanding CAB/RPV use. Clinical Trials Registration. PROSPERO registration CRD42024543919.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.