{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:51:02Z","timestamp":1791989462046,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"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 cabotegravir plus rilpivirine (CAB\u2009+\u2009RPV LA) is highly effective as maintenance therapy in virologically suppressed people with HIV (PWH), but virologic failure (VF) may lead to resistance and compromise future antiretroviral options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter observational study within the French Dat'AIDS cohort, including HIV-1 virologically suppressed adults who switched to CAB\u2009+\u2009RPV LA between December 2021 and December 2023. VF was defined as two consecutive HIV-1 RNA &amp;gt;50\u2005copies\/mL or one &amp;gt;200\u2005copies\/mL. Remaining options were interpreted using ANRS and Stanford algorithms. Cox models identified factors associated with VF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2,196 participants followed for a median of 13 months, VF occurred in 42 individuals (1.9%) after a median of 103 days. Among 26 VF cases undergoing genotype, resistance emerged in 13 (50%), with susceptibility maintained more often for doravirine (ANRS 92%, Stanford 96%) than for dolutegravir\/bictegravir (ANRS 58%, Stanford 65%). Resistance also emerged during low-level viremia or transient rebound with re-suppression (7\/13 cases). In multivariable analysis, higher BMI (aHR 1.07; 95%CI 1.01-1.14), nadir CD4\u2009&amp;lt;\u2009200\u2005cells\/mm3 (aHR 2.44; 1.31-4.56), and prior suppression &amp;lt;12 months (aHR 2.39; 1.01-5.19) were independently associated with VF. Historical CAB and RPV RAMs also increased VF risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CAB\u2009+\u2009RPV LA was associated with low incidence of VF and rare resistance emergence. When resistance occurred, it primarily compromised bictegravir\/dolutegravir rather than doravirine. Low nadir CD4, shorter prior suppression, higher BMI, and historical CAB and\/or RPV RAMs support individualized candidate selection and early resistance testing, even during low-level viremia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag654","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:23:59Z","timestamp":1791804239000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors and Therapeutic Consequences of Virologic Failure With Long-Acting Cabotegravir Plus Rilpivirine in the Dat\u2019AIDS Cohort"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1133-5207","authenticated-orcid":false,"given":"Colin","family":"Deschanvres","sequence":"first","affiliation":[{"name":"Infectious Disease Department, Nantes University Hospital , Inserm 1413, Nantes 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