{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:00:30Z","timestamp":1785427230643,"version":"3.56.0"},"reference-count":19,"publisher":"American Society for Microbiology","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100023961","name":"Centro de Investigaci\u00f3n Biotecnol\u00f3gica en Red de Enfermedades Infecciosas","doi-asserted-by":"crossref","award":["CB21\/13\/00011"],"award-info":[{"award-number":["CB21\/13\/00011"]}],"id":[{"id":"10.13039\/501100023961","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FI23\/00120"],"award-info":[{"award-number":["FI23\/00120"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CD23\/00136"],"award-info":[{"award-number":["CD23\/00136"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023961","name":"Centro de Investigaci\u00f3n Biotecnol\u00f3gica en Red de Enfermedades Infecciosas","doi-asserted-by":"crossref","award":["2171\/2595"],"award-info":[{"award-number":["2171\/2595"]}],"id":[{"id":"10.13039\/501100023961","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100023561","name":"Ministerio de Universidades","doi-asserted-by":"crossref","award":["Margarita Salas"],"award-info":[{"award-number":["Margarita Salas"]}],"id":[{"id":"10.13039\/501100023561","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Factors influencing suboptimal pharmacokinetics (PK) of long-acting (LA) cabotegravir (CAB) and rilpivirine (RPV) in people with HIV (PWH) remain poorly understood. Lower plasma concentrations in underrepresented populations in clinical trials and direct initiation without an oral lead-in (OLI) require further investigation. This study examined CAB and RPV plasma levels in a real-world cohort, focusing on OLI\u2019s role. This prospective cohort study followed PWH transitioning from oral antiretroviral therapy to CAB + RPV injections. Participants were sequentially assigned to start with injections (SWI) or with OLI. Plasma CAB and RPV levels were measured before each injection over 7 months, with virological monitoring up to 11 months. Mixed-effects models were used to identify the predictors of lower CAB and RPV levels, adjusting for OLI use, age, sex, body mass index (BMI), and smoking. Among 172 participants (median age: 48 years, 12.8% female, 14.7% BMI \u226530 kg\/m\u00b2, 45.5% smokers), 81 (47.1%) initiated therapy via SWI, and 91 (52.9%) via OLI. CAB concentrations were lower in participants with higher BMI (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.019), male sex (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.021), and smoking (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.057). RPV levels were reduced in smokers (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011) and younger participants (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.064). PK profiles and virological outcomes were similar between SWI and OLI groups, with trough concentrations above inhibitory thresholds. Rates of virological failure (1 SWI vs. 2 OLI;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.999) and low-level viremia (18.5% vs. 17.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.999) were comparable. Sex, BMI, and smoking influenced CAB and RPV levels, whereas OLI use had no significant impact on PK or virological outcomes, supporting flexible CAB +RPV LA initiation strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00145-25","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T09:01:24Z","timestamp":1749114084000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Influence of patient characteristics and oral lead-in on long-acting cabotegravir and rilpivirine pharmacokinetics and outcomes in people with HIV: a real-world study"],"prefix":"10.1128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9949-8504","authenticated-orcid":false,"given":"Marta","family":"Fern\u00e1ndez-Gonz\u00e1lez","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01jmsem62","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Unit, Hospital General Universitario de Elche","place":["Elche, Spain"]},{"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"publisher"}],"name":"CIBERINFEC, Instituto de Salud Carlos III","place":["Madrid, Spain"]},{"id":[{"id":"https:\/\/ror.org\/0116vew40","id-type":"ROR","asserted-by":"publisher"}],"name":"Fundaci\u00f3n para el Fomento de la Investigaci\u00f3n Sanitaria y Biom\u00e9dica de la Comunitat Valenciana (FISABIO)","place":["Valencia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1571-6090","authenticated-orcid":false,"given":"Guillermo","family":"Telenti","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01jmsem62","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Unit, Hospital General Universitario de Elche","place":["Elche, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8022-364X","authenticated-orcid":false,"given":"Christian","family":"Ledesma","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01jmsem62","id-type":"ROR","asserted-by":"publisher"}],"name":"Infectious Diseases Unit, Hospital General Universitario de Elche","place":["Elche, Spain"]},{"id":[{"id":"https:\/\/ror.org\/0116vew40","id-type":"ROR","asserted-by":"publisher"}],"name":"Fundaci\u00f3n para el Fomento de la Investigaci\u00f3n Sanitaria y Biom\u00e9dica de la Comunitat Valenciana (FISABIO)","place":["Valencia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9083-3692","authenticated-orcid":false,"given":"Mar\u00eda","family":"Losada-Echeberr\u00eda","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01azzms13","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute for Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universidad Miguel Hern\u00e1ndez","place":["Elche, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8113-0795","authenticated-orcid":false,"given":"Enrique","family":"Barraj\u00f3n-Catal\u00e1n","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01azzms13","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute for Research, Development and Innovation in Health Biotechnology of Elche (IDiBE), Universidad Miguel 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Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.00145-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/aac.00145-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T09:01:26Z","timestamp":1749114086000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/aac.00145-25"}},"subtitle":[],"editor":[{"given":"Miguel 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