{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T02:22:56Z","timestamp":1787797376033,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T00:00:00Z","timestamp":1757721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n When using long\u2010acting injectable cabotegravir and rilpivirine (CAB\u2009+\u2009RPV) in individuals with viraemia, beyond small cohorts, little is known about baseline characteristics, virological failure outcomes, resistance emergence, re\u2010suppression and discontinuation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We identified evidence from\n PubMed<\/jats:styled-content>\n ,\n EMBASE<\/jats:styled-content>\n , Cochrane and conference abstract databases through 17 March 2025 to synthesize data from observational cohort studies (\n OCS<\/jats:styled-content>\n ) that reported on virological failure (\n VF<\/jats:styled-content>\n ) events in individuals with viraemia at initiation of\n LA<\/jats:styled-content>\n \u2010I\n CAB<\/jats:styled-content>\n \u2009+\u2009\n RPV<\/jats:styled-content>\n . We extracted data on baseline clinical and socio\u2010demographic characteristics,\n VF<\/jats:styled-content>\n , resistance\u2010associated mutations (\n RAMs<\/jats:styled-content>\n ) at\n VF<\/jats:styled-content>\n , post\u2010\n VF<\/jats:styled-content>\n regimen choice, re\u2010suppression and discontinuation.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Across 14 cohorts including 561 individuals, there were 36\n VF<\/jats:styled-content>\n events (\n OCS<\/jats:styled-content>\n \u2010level\n VF<\/jats:styled-content>\n rate 0% (\n n<\/jats:italic>\n \/\n N<\/jats:italic>\n \u2009=\u20090\/12, 0\/12 and 0\/10) to 25% (\n n<\/jats:italic>\n \/\n N<\/jats:italic>\n \u2009=\u20093\/12)).\n VF<\/jats:styled-content>\n definitions varied. 6\/14\n OCS<\/jats:styled-content>\n (\n n<\/jats:italic>\n \u2009=\u2009436) reported on baseline\n CD4<\/jats:styled-content>\n count, 13\/14 (\n n<\/jats:italic>\n \u2009=\u2009543) on baseline viral load and 7\/14 (\n n<\/jats:italic>\n \u2009=\u2009459) on socio\u2010demographic characteristics. Among the 14\n VF<\/jats:styled-content>\n events with genotypic information available at\n VF<\/jats:styled-content>\n ,\n NNRTI RAMs<\/jats:styled-content>\n were identified in 13\/14 individuals,\n INI RAMs<\/jats:styled-content>\n in 9\/14 and dual\u2010class resistance in 8\/14 individuals. Post\u2010\n VF<\/jats:styled-content>\n regimens were reported for 16\/36 individuals with\n VF<\/jats:styled-content>\n and included lenacapavir (\n LEN<\/jats:styled-content>\n )\u2010based regimens, protease inhibitor (\n PI<\/jats:styled-content>\n )\u2010based regimens or\n LA<\/jats:styled-content>\n \u2010I\n CAB<\/jats:styled-content>\n \u2009+\u2009\n RPV<\/jats:styled-content>\n continuation. Re\u2010suppression outcomes were described in 10\n VF<\/jats:styled-content>\n events: re\u2010suppression occurred in 5\/10.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In\n OCS<\/jats:styled-content>\n , the follow\u2010up duration was short and\n VF<\/jats:styled-content>\n definitions were highly variable, with few cohorts reporting\n VF<\/jats:styled-content>\n outcomes in people with baseline\n VL<\/jats:styled-content>\n >10\u2009000\u2009c\/\n mL<\/jats:styled-content>\n .\n VF<\/jats:styled-content>\n was frequently accompanied by resistance. Post\u2010\n VF<\/jats:styled-content>\n regimens varied, and their success was unclear due to the small sample size.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hiv.70113","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T10:04:12Z","timestamp":1757757852000},"page":"42-57","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of real\u2010world initiation of long\u2010acting injectable cabotegravir and rilpivirine (\n LA<\/scp>\n \u2010I\n CAB<\/scp>\n \u2009+\u2009\n RPV<\/scp>\n ) in individuals with viraemia: A systematic review of baseline characteristics, virological failure outcomes and discontinuations"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1881-5470","authenticated-orcid":false,"given":"Alexa","family":"Elias","sequence":"first","affiliation":[{"name":"SHARE Collaborative, Blizard Institute Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8730-790X","authenticated-orcid":false,"given":"Chlo\u00e9","family":"Pasin","sequence":"additional","affiliation":[{"name":"SHARE Collaborative, Blizard Institute Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Smuk","sequence":"additional","affiliation":[{"name":"SHARE Collaborative, Blizard Institute Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Paterson","sequence":"additional","affiliation":[{"name":"Pandemic Sciences Institute University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6168-6745","authenticated-orcid":false,"given":"Chloe M.","family":"Orkin","sequence":"additional","affiliation":[{"name":"SHARE Collaborative, Blizard Institute Queen Mary University of London London UK"},{"name":"Barts Health NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.70057"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000897"},{"key":"e_1_2_9_4_1","volume-title":"Overview of WHO Recommendations on HIV and Sexually Transmitted Infection Testing, Prevention, Treatment, Care and Service Delivery","year":"2025"},{"key":"e_1_2_9_5_1","unstructured":"VocabriaEU.Summary of product characteristics. 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