LONG-ACTING HIV treatment maintained viral suppression in 94% of patients, with confirmed virologic failure occurring in just 1%.
The findings, presented at IDWeek 2026, provide real-world evidence supporting the effectiveness of injectable cabotegravir plus rilpivirine in people with HIV who previously achieved viral suppression on oral antiretroviral therapy (ART).
Researchers analyzed data from the OPERA cohort, examining 7,995 people with HIV who switched to long-acting cabotegravir plus rilpivirine between January 2021 and December 2025.
Of these, 6,955 (87%) were virologically suppressed at treatment initiation, defined as an HIV viral load below 50 copies/mL. The analysis included 6,362 patients who completed their first two injections within 67 days.
During their first uninterrupted treatment period, 94% had a viral load below 50 copies/mL at their last measurement, while 81% maintained this level across every recorded viral load test.
Confirmed virologic failure occurred in only 1% of patients, defined as two consecutive measurements of at least 200 copies/mL or one such measurement followed by treatment discontinuation.
The cohort included a diverse population, with a median age of 37 years. Overall, 43% were Black, 32% were Hispanic, and 23% were aged 50 years or older.
At study completion, 77% of patients remained in care and receiving long-acting injectable therapy, including those who had experienced treatment interruptions. Median treatment duration was 18 months.
Among 182 provider surveys examining confirmed discontinuations, the most frequently reported reasons were missed injection appointments (29%), loss to care (23%), and preference for returning to oral ART (15%).
The results reinforce the durability of long-acting cabotegravir plus rilpivirine as an alternative to daily oral medication for people with established viral suppression.
However, the findings primarily concern patients already virologically suppressed before switching treatment. Further research is needed to establish effectiveness in those with detectable viral loads or difficulties maintaining oral therapy.
The findings underscore the importance of maintaining engagement in HIV care while supporting long-acting treatment as an effective option for appropriately selected patients.
Reference
Hsu R et al. High suppression and rare virologic failure with long-acting cabotegravir + rilpivirine: real world evidence over five years from the OPERA cohort. Oral Abstract 73. IDWeek, October 21–24, 2026.
Featured Image: bongkarn on Adobe Stock.
Featured Image: bongkarn on Adobe Stock.
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