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Cabotegravir Plus Rilpivirine Long-acting Regimen in the Swiss HIV Cohort Study:Uptake, Outcome, and Risk Factors for Treatment Failures

Recruiting
Conditions
HIV Infections
Interventions
Registration Number
NCT06405464
Lead Sponsor
University of Zurich
Brief Summary

This study aims to characterize Swiss HIV Cohort Study participants initiating the CAB+RPV LA regimen, assess adherence to Swiss label indications, and describe treatment outcomes in this large, multicentre, heterogeneous, high-income setting. Moreover, the study aims to assess virological, immunological, demographic, clinical, and behavioural factors associated with viral failure under CAB+RPV LA regimen.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
600
Inclusion Criteria
  • Participant in the SHCS
  • All SHCS participants initiating the CAB+RPV LA regimen
  • All SHCS participants on SOC oral regimen
Exclusion Criteria
  • Not participating in the SHCS

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Swiss HIV Cohort Study participants on CAB+RPV LA regimenRilpivirine Injectable SuspensionSwiss HIV Cohort Study participants initiating the CAB+RPV LA regimen
Swiss HIV Cohort Study participants on CAB+RPV LA regimenCabotegravir Injectable SuspensionSwiss HIV Cohort Study participants initiating the CAB+RPV LA regimen
Swiss HIV Cohort Study participants on CAB+RPV LA regimenEDURANT 25Mg TabletSwiss HIV Cohort Study participants initiating the CAB+RPV LA regimen
Swiss HIV Cohort Study participants on CAB+RPV LA regimenFull-length sequencingSwiss HIV Cohort Study participants initiating the CAB+RPV LA regimen
Swiss HIV Cohort Study participants on a standard of care oral regimenIntact proviral DNA assayMatched control population on a standard of care oral regimen
Swiss HIV Cohort Study participants on a standard of care oral regimenFull-length sequencingMatched control population on a standard of care oral regimen
Swiss HIV Cohort Study participants on CAB+RPV LA regimenVOCABRIA 30Mg TabletSwiss HIV Cohort Study participants initiating the CAB+RPV LA regimen
Swiss HIV Cohort Study participants on CAB+RPV LA regimenIntact proviral DNA assaySwiss HIV Cohort Study participants initiating the CAB+RPV LA regimen
Primary Outcome Measures
NameTimeMethod
Proportion of participants by characteristicsMonth 24

- Proportion of participants by socio-demographic and clinical characteristic(s) (e.g., by age, sex, body mass index, race, geographic origin, education, transmission mode, HIV-1 RNA levels, CD4 cell count, duration of HIV-1 infection, HIV-1 subtype, previous regimen, genotypic resistance profile, coinfections, lifestyle variables, and co-medications)

Overall adherence to Swiss label indication in CAB+RPV LA prescriptionsMonth 24

- Overall adherence to Swiss label indication in CAB+RPV LA prescriptions between care providers, such as university hospital versus private physicians, and among nationwide centres

Proportion of individuals with viral blipsMonth 24

Proportion of individuals with viral blips (defined as one HIV-1 RNA \>50 and \<400 c/mL with a next HIV-1 RNA \<50 copies/ml)

Time to viral failureUp to month 24

Overall time to confirmed viral failures (defined as two consecutive HIV-1 RNA ≥ 50 c/mL)

Proportion of participants who discontinue treatment due to drug-unrelated reasonsMonth 24

Proportion of participants who discontinue treatment due drug-unrelated reasons and re-suppression regimens (such as patient wish, death, migration, and loss to follow-up) including the choice of re-suppression regimens.

Overall adherence to the proposed injection schedulesMonth 24

- Overall adherence to the proposed injection schedules quantified by deriving an CAB+RPV LA adherence threshold (e.g., accounting for any missed injection, daily oral bridging ART, and delayed injection of +7 days according to the Swiss label indication)

Proportion of individuals with confirmed viral failuresMonth 24

Proportion of individuals with confirmed viral failures (defined as two consecutive HIV-1 RNA ≥ 50 c/mL)

Proportion of individuals switching off CAB+RPV LA to previous or another oral regimenMonth 24

Proportion of individuals switching off CAB+RPV LA to previous or another oral regimen after HIV-1 RNA levels of \>50 to \<400 copies/mL and \>400 copies/mL

Proportion of participants who discontinue treatment due to drug-related reasonsMonth 24

Proportion of participants who discontinue treatment due drug-related reasons and re-suppression regimens (such as adverse events, confirmed viral failure, low level viremia or low blood concentration measurements) including the choice of re-suppression regimens.

Proportion of participants by treatment adherence categoryMonth 24

- Proportion of participants by treatment adherence categories (e.g., optimal, sub-optimal, and poor adherence)

Secondary Outcome Measures
NameTimeMethod
Measure intact proviral DNA as potential predictor for viral failureMonth 24

Measure intact proviral DNA as potential predictor for viral failure among PWH initiating CAB+RPV LA regimen and compare with the matched control population on a SOC oral regimen

Assessment of resistance associated mutations from proviral DNA as potential predictor for viral failureMonth 24

Assessment of resistance associated mutations from proviral DNA as potential predictor for viral failure among PWH initiating CAB+RPV LA regimen and compare with the matched control population on a SOC oral regimen

Investigate in-depth factors associated with viral blips and viral failureMonth 24

Proportion of individuals by risk factor(s) (e.g., by body mass index, race, geographic origin, education, HIV-1 RNA levels, CD4 cell count, duration of HIV-1 infection, HIV-1 subtype, previous regimen, treatment adherence, CAB+RPV LA plasma concentrations measured at time of failure, genotypic resistance profile , lifestyle variables, and co-medications)

Trial Locations

Locations (1)

University Hospital Zurich

🇨🇭

Zurich, Switzerland

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