P-559. Characteristics of Women Initiating CAB+RPV LA in the OPERA Cohort
Authors: Altamirano Jessica A , Levis Brooke , Markarian Cindy , Cochran Quateka , Sherman Courtney , Toeque Mona-Gekanju , Armas Laura , Sridhar Gayathri , Vannappagari Vani , Brown Kimberley , Fusco Jennifer S 
Published: January 2025

Background

Cabotegravir + rilpivirine long-acting (CAB+RPV LA) injectable administered once a month or every two months is the first complete LA antiretroviral (ART) regimen approved for HIV-1 treatment. It is indicated for treatment experienced individuals with viral loads (VL) &lt; 50 copies/mL. CAB+RPV LA has attributes that may make it a good option for women, who represent ∼20% of people with HIV in the US and may experience unique challenges with HIV treatment. CAB+RPV LA may reduce psychosocial concerns around adherence, stigma, and disclosure associated with daily oral therapy. We assessed baseline characteristics and dosing schedules among women receiving CAB+RPV LA in the OPERA® cohort.

Methods

Adult and adolescent women ≥ 13 years old with HIV who received ≥ 1 CAB+RPV LA injection between 21JAN2021-31AUG2023 were included. Baseline characteristics and dosing schedules were described overall and stratified by VL at first injection (&lt; 50 vs. ≥ 50 copies/mL).

Results

Of 533 women in 19 states and Puerto Rico starting CAB+RPV LA (78% with VL &lt; 50 copies/mL, 20% with VL ≥ 50 copies/mL, 2% missing VL), 11% were transgender, 67% were Black, 17% were Hispanic, and 64% were of childbearing age (13-49 years; Table 1). Almost all had medical coverage (1% paid cash). Median years since HIV diagnosis was 9 (IQR: 3, 19), median BMI was 30 (IQR: 26, 35), 82% had ≥ 1 comorbidity, and 27% had an AIDS-defining illness (Table 2). Women received a median of 2 (IQR: 1, 2) core agents prior to CAB+RPV LA and 67% were on INSTIs immediately prior to CAB+RPV LA (Table 3). Of 508 women with dosing information, 96% were on Q2M schedules. Compared to women with VL &lt; 50 copies/mL, women with VL ≥ 50 copies/mL had longer disease duration, higher VACS scores, and lower CD4 cell counts. They were more likely to have an AIDS-defining illness and have experienced ≥ 3 core agents.

Conclusion

To date, &gt; 500 women in OPERA have received CAB+RPV LA injections; most started the regimen early in their HIV treatment journey, with notable diversity across racial and ethnic groups. One in five women started the regimen while having a detectable VL; these women had more advanced HIV and were more treatment-experienced, with potentially fewer ARV options. Our findings provide unique insights about this important but understudied subpopulation of people with HIV.

Disclosures

Jessica A. Altamirano, MD, FIDSA, Gilead Sciences: Speaker's Bureau Brooke Levis, PhD, EMD Serono: Research support to my employer|Gilead Sciences: Research support to my employer|Merck & Co.: Research support to my employer|TheraTechnologies: Research support to my employer|ViiV Healthcare: Research support to my employer Laura Armas, MD, FACP, AAHIVS, Gilead: Advisor/Consultant|Gilead: Grant/Research Support Gayathri Sridhar, MBBS, MPH, PhD, GlaxoSmithKline: Stocks/Bonds (Public Company)|ViiV Healthcare: Full Time Employee Vani Vannappagari, MBBS, MPH, PhD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Full time Employee|ViiV Healthcare: Stocks/Bonds (Public Company) Kimberley Brown, PharmD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Jennifer S. Fusco, BS, EMD Serono: Research support to my employer|Gilead Sciences: Research support to my employer|Merck & Co.: Research support to my employer|TheraTechnologies: Research support to my employer|ViiV Healthcare: Research support to my employer