{"doi":"10.1093/cid/ciaf425","title":"Long-Acting Cabotegravir/Rilpivirine, Lenacapavir, and Ibalizumab Use Among Persons With HIV-1 Viremia at a Ryan White-Funded Clinic in the Urban US South","abstract":"BACKGROUND: People with HIV (PWH) with viremia despite oral antiretroviral therapy (ART) can achieve viral suppression (VS) using long-acting (LA)-ART. Scaling this approach has lagged, especially in the highest HIV burden areas. METHODS: We performed a retrospective review of PWH who initiated LA-ART (cabotegravir/rilpivirine [CAB/RPV] ± lenacapavir [LEN] ± ibalizumab [IBA]) with viremia (≥50 c/mL) at a Ryan White-funded program in the urban South between 14 April 2021 and 31 August 2024. Among PWH who received ≥3 LA-CAB/RPV injections through end of follow-up (31 December 2024), achieving VS (<50 c/mL) was assessed. RESULTS: Eighty-one PWH with viremia initiated LA-ART. Among them, 93% identified as Black, 40% were cis-/trans-women, the median (Q1-Q3) age was 38 (30-49) years, and the median income was $25K/year ($20-33K/year). The median (Q1-Q3) time since HIV diagnosis was 15.5 (8.8-20.5) years, and 46% had prior opportunistic conditions. At LA-ART initiation (56 CAB/RPV; 22 CAB ± RPV + LEN; 3 CAB ± RPV + LEN + IBA), the median (Q1-Q3) viral load was 4.0 (2.9-4.8) log10 and CD4 + 186 (62-420) cells/μL. Of 79 PWH who remained engaged, 73 (92%) achieved VS after a median (Q1-Q3) of 1 (1-2) injection, with CD4 rise to 353 (187-501) cells/μL. Otherwise, 2 had virologic failure with drug resistance; 4 had persistent viremia without resistance (>200 c/mL [n = 2]; 50-200 c/mL [n = 2]). Of 645 LA-CAB/RPV injections (500 Q4wk; 145 Q8wk), 635 (98%) were administered on-time; all LEN (43/43) and IBA (37/37) administrations occurred on-time. CONCLUSIONS: In the largest southern US cohort of PWH with viremia initiating LA-ART, 92% achieved VS despite significant barriers to care and disease burden, underscoring LA-ART as a tool to help achieve Ending the HIV Epidemic goals.","journal":"Clinical Infectious Diseases","year":2025,"id":519950,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9528,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1270990,"name":"Amalia Aldredge","orcid":"0000-0002-8044-4298","position":1,"is_corresponding":false},{"id":1226485,"name":"Larisa Niles-Carnes","orcid":"0000-0002-6817-4969","position":2,"is_corresponding":false},{"id":1389539,"name":"Eudiah Ochieng","orcid":null,"position":3,"is_corresponding":false},{"id":1389540,"name":"Priyasha Pareek","orcid":null,"position":4,"is_corresponding":false},{"id":1389541,"name":"Vickie Robinson","orcid":null,"position":5,"is_corresponding":false},{"id":1388932,"name":"Erica Anderson","orcid":"0009-0002-6407-4191","position":6,"is_corresponding":false},{"id":1389542,"name":"Mary Carmen Amigo Castañeda","orcid":null,"position":7,"is_corresponding":false},{"id":1389543,"name":"Hilary Spralling","orcid":null,"position":8,"is_corresponding":false},{"id":857958,"name":"Bradley L. Smith","orcid":"0000-0003-4540-1433","position":9,"is_corresponding":false},{"id":858482,"name":"Jeri Sumitani","orcid":null,"position":10,"is_corresponding":false},{"id":1227010,"name":"Eric Paul Leue","orcid":null,"position":11,"is_corresponding":false},{"id":414456,"name":"Caitlin A. Moran","orcid":"0000-0001-8436-0465","position":12,"is_corresponding":false},{"id":1388933,"name":"Meredith Lora","orcid":"0009-0004-5999-6655","position":13,"is_corresponding":false},{"id":350505,"name":"Wendy S. Armstrong","orcid":"0000-0002-7316-2276","position":14,"is_corresponding":false},{"id":301947,"name":"Lauren F. Collins","orcid":"0000-0002-0170-5454","position":15,"is_corresponding":false},{"id":437628,"name":"Jonathan Colasanti","orcid":"0000-0002-0536-9769","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T02:49:23.618703Z","pmid":"40747944","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}