{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:21:19Z","timestamp":1790385679545,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020953","name":"Taiwan Centers for Disease Control","doi-asserted-by":"publisher","award":["MOHW113-CDC-C-114-000106"],"award-info":[{"award-number":["MOHW113-CDC-C-114-000106"]}],"id":[{"id":"10.13039\/100020953","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG3M1582"],"award-info":[{"award-number":["CMRPG3M1582"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-acting injectable cabotegravir plus rilpivirine (LA CAB+RPV) is approved for virally suppressed people with human immunodeficiency virus 1 (HIV-1), but evidence for its use in those with persistent viremia and adherence challenges remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter, open-label, randomized study involving oral antiretroviral therapy (ART)-experienced people with HIV who had been diagnosed with HIV for at least 12 months and a most recent HIV-1 RNA level of at least 200 copies per milliliter. Participants with resistance-associated mutations to CAB or RPV were excluded. Eligible participants were randomly assigned in a 1:1 ratio to receive immediate LA CAB+RPV or to continue standard oral therapy until Week 24 (delayed-switch group). The primary endpoint was the proportion of participants with an HIV-1 RNA level of &amp;lt;200 copies per milliliter at Week 24.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 61 randomized participants, 45 met eligibility criteria and were included in the analysis; 91% were male, and the median baseline HIV-1 RNA was 35 000\u2005copies\/mL. At Week 24, viral suppression was achieved in 88.0% (22\/25) in the immediate LA group versus 55.0% (11\/20) in the delayed-switch group (relative risk for failure to achieve viral suppression, 0.27; 95% CI, 0.08\u20130.86; P = .026). The effect of LA CAB+RPV was sustained through Week 52.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among people with HIV and viremia associated with adherence challenges, immediate initiation of LA CAB+RPV resulted in higher rates of viral suppression than continued oral ART, supporting its use beyond populations with stable suppression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag504","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:45:18Z","timestamp":1787139918000},"source":"Crossref","is-referenced-by-count":1,"title":["Direct Initiation of Long-Acting Cabotegravir Plus Rilpivirine in People With HIV and Suboptimal Virologic Suppression: A Randomized Trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8922-397X","authenticated-orcid":false,"given":"Nan-Yu","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]},{"name":"School of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0629-9790","authenticated-orcid":false,"given":"Cheng-Pin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6256-0527","authenticated-orcid":false,"given":"Shu-Hsing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shien-Shian","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Keelung Chang Gung Memorial Hospital , Keelung ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Yuan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Keelung Chang Gung Memorial Hospital , Keelung ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Tai","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]},{"name":"School of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]},{"name":"Division of Infectious Diseases, Taipei Chang Gung Memorial Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6710-3432","authenticated-orcid":false,"given":"Ting-Shu","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]},{"name":"School of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Yi","family":"Su","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]},{"name":"Division of Infectious Diseases, Taipei Chang Gung Memorial Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-5205","authenticated-orcid":false,"given":"Shian-Sen","family":"Shie","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Jr","family":"Ye","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Keelung Chang Gung Memorial Hospital , Keelung ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4136-3911","authenticated-orcid":false,"given":"Chun-Fu","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7756-8484","authenticated-orcid":false,"given":"Peng-Hao","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Kei","family":"Lao","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Hsiang","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4079-8697","authenticated-orcid":false,"given":"Zhuo-Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Medicine, Chang Gung University , Taoyuan ,","place":["Taiwan"]},{"name":"Department of Neurosurgery, Chang Gung Memorial Hospital Linkou Branch , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1886-0370","authenticated-orcid":false,"given":"Chien-Yu","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan ,","place":["Taiwan"]},{"name":"Institute of Public Health, School of Medicine, National Yang-Ming Chiao Tung University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"2026092508261032500_ciag504-B1","doi-asserted-by":"crossref","first-page":"e587","DOI":"10.1016\/S2352-3018(25)00096-7","article-title":"Oral antiretroviral adherence interventions in the era of U=U","volume":"12","author":"Keene","year":"2025","journal-title":"Lancet HIV"},{"key":"2026092508261032500_ciag504-B2","doi-asserted-by":"crossref","DOI":"10.1016\/j.ypmed.2020.106182","article-title":"Prevalence, determinants, and impact of suboptimal adherence to HIV medication in 25 countries","volume":"139","author":"de Los Rios","year":"2020","journal-title":"Prev Med"},{"key":"2026092508261032500_ciag504-B3","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1056\/NEJMms1513641","article-title":"Applying public health principles to the HIV epidemic\u2013how are we doing?","volume":"373","author":"Frieden","year":"2015","journal-title":"N Engl J Med"},{"key":"2026092508261032500_ciag504-B4","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s10461-022-03817-z","article-title":"Long-acting injectable therapy for people with HIV: looking ahead with lessons from psychiatry and addiction medicine","volume":"27","author":"Edwards","year":"2023","journal-title":"AIDS Behav"},{"key":"2026092508261032500_ciag504-B5","doi-asserted-by":"crossref","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"},{"key":"2026092508261032500_ciag504-B6","doi-asserted-by":"crossref","first-page":"e566","DOI":"10.1016\/S2352-3018(23)00136-4","article-title":"Efficacy, safety, and tolerability of switching to long-acting cabotegravir plus rilpivirine versus continuing fixed-dose bictegravir, emtricitabine, and tenofovir alafenamide in virologically suppressed adults with HIV, 12-month results (SOLAR): a randomised, open-label, phase 3b, non-inferiority trial","volume":"10","author":"Ramgopal","year":"2023","journal-title":"Lancet HIV"},{"key":"2026092508261032500_ciag504-B7","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1038\/s41591-025-04041-7","article-title":"Cabotegravir and rilpivirine for treatment of HIV infection in Africa: week 96 results from the phase 3b randomized, open-label, noninferiority CARES trial","volume":"32","author":"Kityo","year":"2026","journal-title":"Nat Med"},{"key":"2026092508261032500_ciag504-B8","doi-asserted-by":"crossref","first-page":"e645","DOI":"10.1093\/cid\/ciac631","article-title":"First demonstration project of long-acting injectable antiretroviral therapy for persons with and without detectable human immunodeficiency virus (HIV) viremia in an urban HIV clinic","volume":"76","author":"Christopoulos","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2026092508261032500_ciag504-B9","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1093\/cid\/ciae500","article-title":"Viral suppression rates at 48 weeks in people with HIV starting long-acting cabotegravir\/rilpivirine with initial viremia","volume":"80","author":"Hickey","year":"2025","journal-title":"Clin Infect Dis"},{"key":"2026092508261032500_ciag504-B10","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1093\/cid\/ciaf425","article-title":"Long-acting cabotegravir\/rilpivirine, lenacapavir, and ibalizumab use among persons with HIV-1 viremia at a Ryan White-funded clinic in the urban U.S. South","volume":"82","author":"Colasanti","year":"2025","journal-title":"Clin Infect Dis"},{"key":"2026092508261032500_ciag504-B11","author":"Cresswell"},{"key":"2026092508261032500_ciag504-B12","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1056\/NEJMoa2508228","article-title":"Cabotegravir plus rilpivirine for persons with HIV and adherence challenges","volume":"394","author":"Rana","year":"2026","journal-title":"N Engl J Med"},{"key":"2026092508261032500_ciag504-B13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ijid.2020.02.004","article-title":"Shall I trust the report? Variable performance of Sanger sequencing revealed by deep sequencing on HIV drug resistance mutation detection","volume":"93","author":"Chen","year":"2020","journal-title":"Int J Infect Dis"},{"key":"2026092508261032500_ciag504-B14","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1093\/cid\/ciaf161","article-title":"Utilizing HIV proviral DNA to assess for the presence of HIV drug resistance","volume":"81","author":"Wensing","year":"2025","journal-title":"Clin Infect Dis"},{"key":"2026092508261032500_ciag504-B15","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1001\/archpsyc.1965.01720310065008","article-title":"A self-rating depression scale","volume":"12","author":"Zung","year":"1965","journal-title":"Arch Gen Psychiatry"},{"key":"2026092508261032500_ciag504-B16","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s13012-017-0635-3","article-title":"Psychometric assessment of three newly developed implementation outcome measures","volume":"12","author":"Weiner","year":"2017","journal-title":"Implement Sci"},{"key":"2026092508261032500_ciag504-B17","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1001\/jama.2025.0109","article-title":"HIV viral suppression with use of long-acting antiretroviral therapy in people with and without initial viremia","volume":"333","author":"Spinelli","year":"2025","journal-title":"JAMA"},{"key":"2026092508261032500_ciag504-B18","doi-asserted-by":"crossref","first-page":"2807","DOI":"10.1007\/s40121-023-00890-2","article-title":"Cabotegravir + rilpivirine long-acting injections for HIV treatment in the US: real world data from the OPERA cohort","volume":"12","author":"Sension","year":"2023","journal-title":"Infect Dis Ther"},{"key":"2026092508261032500_ciag504-B19","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1016\/S0140-6736(20)32666-0","article-title":"Long-acting cabotegravir and rilpivirine dosed every 2 months in adults with HIV-1 infection (ATLAS-2M), 48-week results: a randomised, multicentre, open-label, phase 3b, non-inferiority study","volume":"396","author":"Overton","year":"2021","journal-title":"Lancet"},{"key":"2026092508261032500_ciag504-B20","doi-asserted-by":"crossref","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"},{"key":"2026092508261032500_ciag504-B21","author":"Jonsson-Oldenb\u00fcttel"},{"key":"2026092508261032500_ciag504-B22","author":"Rolle"},{"key":"2026092508261032500_ciag504-B23","author":"Hessamfar"},{"key":"2026092508261032500_ciag504-B24","author":"Levis"},{"key":"2026092508261032500_ciag504-B25","author":"Nguyen"},{"key":"2026092508261032500_ciag504-B26","doi-asserted-by":"crossref","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":"Cutrell","year":"2021","journal-title":"AIDS"},{"key":"2026092508261032500_ciag504-B27","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofad390","article-title":"Projected benefits of long-acting antiretroviral therapy in nonsuppressed people with human immunodeficiency virus experiencing adherence barriers","volume":"10","author":"Chen","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"2026092508261032500_ciag504-B28","doi-asserted-by":"crossref","first-page":"e591","DOI":"10.1093\/cid\/ciaf428","article-title":"Clinical consequences of delaying implementation of long-acting antiretroviral therapy for people with HIV and persistent viremia in the United States","volume":"81","author":"Pei","year":"2026","journal-title":"Clin Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciag504\/70894267\/ciag504.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciag504\/70894267\/ciag504.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:26:20Z","timestamp":1790339180000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciag504\/8778539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":28,"URL":"https:\/\/doi.org\/10.1093\/cid\/ciag504","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"article-number":"ciag504"}}