Selected people with HIV aged 60 years and older receiving long-acting cabotegravir plus rilpivirine demonstrated high observed rates of virological suppression, treatment persistence, and injection-schedule adherence, according to findings from the nationwide Spanish RELATIVITY cohort published in Aging Clinical and Experimental Research. Among participants aged 60 and older, observed virological suppression reached 97.3 percent compared to 96.5 percent in younger participants under 60 years of age, while virological failure occurred in 0.2 percent versus 0.9 percent. Definitive treatment discontinuation was observed in 11.3 percent of older participants compared to 11.0 percent of younger participants.

The nationwide ambispective RELATIVITY cohort analysis evaluated virologically suppressed adults who initiated long-acting cabotegravir plus rilpivirine by December 31, 2024, across 53 clinical centers in Spain, with the study registered under ClinicalTrials.gov identifier NCT07703748. Out of 3,349 total participants, 407 individuals, or 12.2 percent of the cohort, were aged 60 years or older. In this older subset, the median age was 63.0 years with an interquartile range of 61.0 to 66.8 years, comprising 349 participants aged 60 to 69 years, 54 aged 70 to 79 years, and four aged 80 years or older.

Baseline assessments addressed a population in which evidence on long-acting cabotegravir plus rilpivirine has historically remained limited. Participants aged 60 and older presented with a higher comorbidity burden, having a median of 2 comorbidities compared to a median of 0 in participants under 60 years. Older participants also had longer prior antiretroviral exposure, with a median of 18 years compared to 9 years in the younger group. Median follow-up time was 26.5 months for participants aged 60 and older versus 25.1 months for those younger than 60.

Persistence was assessed through Kaplan–Meier estimates and multivariable Cox proportional hazards regression models. Following adjustment, age 60 years or older was not clearly associated with definitive discontinuation, yielding a hazard ratio of 0.93 with a 95 percent confidence interval of 0.63 to 1.36. High injection-schedule adherence, defined as reaching at least 90 percent adherence, was observed in 99.5 percent of participants aged 60 and older compared to 99.3 percent among participants aged under 60.

The researchers also evaluated an exploratory age-by-comorbidity interaction, reporting an interaction hazard ratio of 1.34 with a 95 percent confidence interval of 1.07 to 1.67, with a hazard ratio per comorbidity in the older group of 1.20 and a 95 percent confidence interval of 0.99 to 1.46. The authors concluded that comorbidity burden may inform closer follow-up in clinical practice, though this exploratory finding requires confirmation, and emphasized that evidence remains limited for people with HIV aged 70 years and older.

Subject of Research: Long-acting cabotegravir and rilpivirine outcomes in older people with HIV

Article Title: Long-acting cabotegravir plus rilpivirine in people with HIV aged ≥ 60 years: persistence, virological outcomes, and comorbidity burden in the spanish RELATIVITY Cohort

Article References: Troya, J., Cabello-Clotet, N., Busca, C., Galindo, M. J., María Martínez, R., Alemán, M. R., de Lagarde, M., Torralba, M., Crusells, M. J., Fanjul, F., Rodríguez, A., Runza, P., Gisbert, L., Hidalgo-Tenorio, C., Morano, L. E., Poquet-Catalá, I., Tiraboschi, J., Romero, A., Alcaraz, A., … Buzón-Martín, L. (2026). Long-acting cabotegravir plus rilpivirine in people with HIV aged ≥ 60 years: persistence, virological outcomes, and comorbidity burden in the spanish RELATIVITY Cohort. Aging Clinical and Experimental Research. https://doi.org/10.1007/s40520-026-03562-6

Image Credits: AI Generated

DOI: 10.1007/s40520-026-03562-6

Keywords: HIV, cabotegravir, rilpivirine, long-acting antiretroviral therapy, RELATIVITY cohort, virological suppression, treatment persistence, older adults, Long-acting, plus, people, aged