Evidence map›Paper›PMID 40042896›Full record

ArticleThe Journal of infectious diseases2025

Impact of Switching to Long-Acting Injectable Cabotegravir Plus Rilpivirine on Rectal HIV-1 RNA Shedding and Implications for Transmission Risk.

Mar Masiá, Marta Fernández-González, Christian Ledesma, Maria Losada-Echeberría, Nieves Gonzalo-Jiménez, Paula Mascarell, Javier García-Abellán, Leandro López, Melissa Bello-Pérez, Sergio Padilla and 1 more

Abstract read
In one paragraph

Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mar MasiáInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0001-9878-2458
Marta Fernández-GonzálezInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0001-9949-8504
Christian LedesmaInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0009-0000-8022-364X
Maria Losada-EcheberríaInstitute for Research, Development, and Innovation in Health Biotechnology of Elche, Universidad Miguel Hernández, Elche, Spain.ORCID 0000-0002-9083-3692
Nieves Gonzalo-JiménezCIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.ORCID 0000-0001-6013-4228
Paula MascarellInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0002-0566-0935
Javier García-AbellánInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0002-5217-3726
Leandro LópezInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0002-3379-1086
Melissa Bello-PérezInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0002-9212-083X
Sergio PadillaInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0002-8420-7310
Felix GutiérrezInfectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain.ORCID 0000-0002-9485-6867

Funding

Consorcio Centro de Investigación Biomédica en Red CB21/13/00011European UnionInstituto de Salud Carlos III PI22/01949Ministerio de Ciencia e Innovación
6 · The paper itself

Abstract

backgroundThe impact of long-acting injectable cabotegravir plus rilpivirine (CAB/RPV) on rectal human immunodeficiency virus 1 (HIV-1) RNA dynamics and the factors associated with viral shedding remain poorly understood.

methodsThis prospective study evaluated HIV-1 RNA dynamics by analyzing sequential paired plasma and rectal fluid samples from virologically suppressed individuals who transitioned from oral antiretroviral therapy (ART) to every-2-month CAB/RPV (preceded or not by oral lead-in), over a 9-month follow-up period. RPV trough concentrations were measured in 384 rectal samples.

resultsIn total, 597 plasma and 561 rectal samples from 90 participants were analyzed. HIV-1 RNA >50 (>1.69 log10) copies/swab was detected in 14.7% (59/401) of rectal samples (42.2% of participants) during intramuscular CAB/RPV, and in 17.5% (28/160) of rectal samples (29% of participants) during oral ART. Median detectable rectal HIV-1 RNA level during intramuscular ART was 362 (range, 133-2216) copies/swab. The frequency and quantity of rectal shedding did not differ between groups with/without oral lead-in. No correlation was observed between rectal shedding and detectable plasma HIV-1 RNA. Median rectal RPV concentration was 3.07 (quartile 1-quartile 3, 2.83-3.35) log10 ng/swab, 1.6-fold above the 90% maximum effective concentration (EC90) for rectal tissue, and did not correlate with rectal HIV-1 RNA levels. Rectal shedding was associated with plasma pre-ART HIV-1 RNA >5 log10 in multivariate Cox regression, but was unrelated to established predictors of virological failure with CAB/RPV.

conclusionsRectal HIV-1 shedding is common during bimonthly intramuscular CAB/RPV treatment and is also observed with oral ART. Shedding was independent of concurrent plasma HIV-1 RNA and rectal RPV concentrations, and was associated with pre-ART viral load.

Indexed as

Anti-HIV AgentsHIV-1HIV InfectionsPyridonesRectumRilpivirineVirus SheddingAdultDiketopiperazinesFemaleHumansInjections, IntramuscularMaleMiddle AgedProspective StudiesRNA, ViralAnti-HIV AgentscabotegravirDiketopiperazinesPyridonesRilpivirineRNA, ViralcabotegravirHIV transmission riskpharmacokineticrectal sheddingrilpivirine

Identifiers

PMID40042896
PMCPMC11998577

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.