{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:58:15Z","timestamp":1792979895130,"version":"4.5.0"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"13","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Cabotegravir\/rilpivirine (CAB\/RPV) is the first long-acting antiretroviral therapy for patients with human immunodeficiency virus (HIV). It is administered via intramuscular injection into the gluteal muscle, requiring precise technique. We report the case of a patient living with HIV who developed resistance to CAB despite on-time administration of all doses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>A 34-year-old man with a body mass index (BMI) of 38.42 kg\/m2 who received therapy with CAB\/RPV 600 mg\/900 mg intramuscularly every other month for 15 months presented to the clinic for routine HIV care. An HIV viral load obtained just before the visit demonstrated a significant elevation in his viral load, which was previously undetectable. Further testing demonstrated the development of a G118R resistance-associated mutation in the virus with a class-wide effect on integrase inhibitors. Upon review, it was determined that the patient had received all doses of his medication with a 1.5-inch needle rather than the recommended 2-inch needle based on his BMI. He was subsequently switched to darunavir\/cobicistat\/emtricitabine\/tenofovir alafenamide and quickly achieved viral suppression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This case demonstrates the potential for patients living with HIV to develop resistance to CAB\/RPV despite on-time administration of the medication. Proper administration and timing of antiretroviral therapy for these patients is essential to ensure efficacy and safety in the management of HIV but does not completely prevent development of resistance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxaf078","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T17:52:24Z","timestamp":1745257944000},"page":"e596-e599","source":"Crossref","is-referenced-by-count":2,"title":["Cabotegravir\/rilpivirine resistance in a patient living with HIV despite on-time administration: A case report"],"prefix":"10.1093","volume":"82","author":[{"given":"Trent G","family":"Towne","sequence":"first","affiliation":[{"name":"Parkview Specialty Pharmacy, Parkview Regional Medical Center , Fort Wayne, IN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis R","family":"Hays","sequence":"additional","affiliation":[{"name":"PPG Infectious Diseases, Parkview Regional Medical Center , Fort Wayne, IN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"2025062720413989500_CIT0001","volume-title":"Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV","author":"Panel on Antiretroviral Guidelines for Adults and Adolescents","year":"2024"},{"key":"2025062720413989500_CIT0002","author":"Cabenuva","year":"2021","journal-title":"Prescribing information"},{"issue":"12","key":"2025062720413989500_CIT0003","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1056\/NEJMoa1909512","article-title":"Long-acting cabotegravir and rilpivirine after oral induction for HIV-1 infection","volume":"382","author":"Orkin","year":"2020","journal-title":"N Engl J Med"},{"issue":"12","key":"2025062720413989500_CIT0004","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1056\/NEJMoa1904398","article-title":"Long-acting cabotegravir and rilpivirine for maintenance of HIV-1 suppression","volume":"382","author":"Swindells","year":"2020","journal-title":"N Engl J Med"},{"issue":"10267","key":"2025062720413989500_CIT0005","doi-asserted-by":"publisher","first-page":"1994","DOI":"10.1093\/cid\/ciad020","article-title":"Long-acting cabotegravir and rilpivirine dosed every 2 months in adults with HIV-1 infection (ATLAS-2M), 48-week results: a randomized, multicentre, open-label, phase 3b, non-inferiority study","volume":"396","author":"Overton","year":"2020","journal-title":"Lancet"},{"issue":"9","key":"2025062720413989500_CIT0006","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1097\/QAD.0000000000002883","article-title":"Exploring predictors of HIV-1 virologic failure to long-acting cabotegravir and rilpivirine: a multivariable analysis","volume":"35","author":"Curtell","year":"2021","journal-title":"AIDS"},{"key":"2025062720413989500_CIT0007","volume-title":"The Use of the WHO-UMC System for Standardised Case Causality Assessment","author":"World Health Organization\u2013Uppsala Monitoring Center","year":"2013"},{"key":"2025062720413989500_CIT0008","doi-asserted-by":"publisher","first-page":"105427","DOI":"10.1016\/j.antiviral.2022.105427","article-title":"Genotypic correlates of resistance to the HIV-1 strand transfer integrase inhibitor cabotegravir","volume":"208","author":"Rhee","year":"2022","journal-title":"Antiviral Res"},{"key":"2025062720413989500_CIT0009","author":"Stanford University HIV Drug Resistance Database"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxaf078\/62768910\/zxaf078.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/13\/e596\/62768910\/zxaf078.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/13\/e596\/62768910\/zxaf078.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T00:41:43Z","timestamp":1751071303000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/82\/13\/e596\/8097638"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":9,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,3,27]]},"published-print":{"date-parts":[[2025,6,26]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxaf078","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7,1]]},"published":{"date-parts":[[2025,3,27]]}}}