{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:18:49Z","timestamp":1791544729831,"version":"4.3.4"},"reference-count":83,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["2024_MV_001"],"award-info":[{"award-number":["2024_MV_001"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 AI007387"],"award-info":[{"award-number":["T32 AI007387"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24 HL166024"],"award-info":[{"award-number":["K24 HL166024"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 AI143470"],"award-info":[{"award-number":["K23 AI143470"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The long-acting injectable regimen of cabotegravir plus rilpivirine (CAB\/RPV) emerged as an alternative to oral standard-of-care integrase strand transfer inhibitor (INSTI)\u2013based 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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\u201352). We used single-proportion meta-analysis to summarize outcomes in 3 populations: antiretroviral therapy (ART)\u2013naive 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-three studies (N = 9224) reported VF prevalence. Nineteen studies (N = 5662) reported resistance data. VF prevalence was 1% (95% CI: 1%\u20133%) in induction-maintenance studies, 1% (1%\u20132%) in switch-suppressed studies, and 5% (3%\u201310%) in switch-viremic studies. INSTI resistance prevalence among successfully genotyped participants at failure was 71% (25%\u201395%), 61% (44%\u201375%), and 41% (20%\u201365%) respectively. Dolutegravir cross-resistance was common (64% of those with emergent resistance).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although VF rates with CAB\/RPV were low, INSTI resistance emerged in approximately 40%\u201370% 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.<\/jats:p>\n                    <jats:p>Clinical Trials Registration. PROSPERO registration CRD42024543919.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciae631","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T07:21:06Z","timestamp":1735111266000},"page":"274-285","source":"Crossref","is-referenced-by-count":26,"title":["Virologic Failure and Emergent Integrase Strand Transfer Inhibitor Drug Resistance With Long-Acting Cabotegravir for HIV Treatment: A Meta-analysis"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-4032","authenticated-orcid":false,"given":"Andrea","family":"Perez Navarro","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Imperial College London , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron T","family":"Nutt","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3506-842X","authenticated-orcid":false,"given":"Mark J","family":"Siedner","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Clinical Research Department, Africa Health Research Institute , KwaZulu-Natal ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8463-5430","authenticated-orcid":false,"given":"Suzanne M","family":"McCluskey","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6494-7645","authenticated-orcid":false,"given":"Andrew","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of Liverpool , Liverpool ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"2025091917001210200_ciae631-B1","author":"World Health Organization","year":"2024"},{"key":"2025091917001210200_ciae631-B2","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1186\/s13643-020-01524-1","article-title":"Factors associated with antiretroviral treatment failure among people living with HIV on antiretroviral therapy in resource-poor settings: a systematic review and 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