Long‐acting cabotegravir and rilpivirine in people with HIV receiving chronic anticoagulation: A real‐world case series
Montserrat Laguno, Berta Torres, Maria Martínez‐Rebollar, Paula Arreba, Octavi Roman, Roger LLobet, Leire Berrocal, Alberto Foncillas, Júlia Calvo, Abiu Sempere, Ivan Chivite, Elisa de Lazzari, Josep Mallolas, Ana González‐CordónBackground
Long‐acting intramuscular cabotegravir plus rilpivirine (LA‐CAB + RPV) is an effective maintenance antiretroviral regimen for virologically suppressed people with HIV. However, its use in individuals receiving chronic anticoagulation is limited by concerns regarding intramuscular bleeding risk, and real‐world data are scarce.
Methods
We conducted an observational, prospective, single‐centre cohort study including all people with HIV (PVIH) who initiated LA‐CAB + RPV at Hospital Clínic of Barcelona since February 2023 until April 2026. Patients receiving chronic anticoagulation during the follow‐up were identified and assessed for safety and virological outcomes.
Results
Among 964 PVIH who started LA‐CAB + RPV in our cohort, three were identified who received concomitantly chronic anticoagulation (direct oral anticoagulants or low‐molecular‐weight heparin). They received injections using standard deep intramuscular technique with post‐injection compression. No clinically relevant injection‐site hematomas or haemorrhagic complications were observed. Viral suppression was maintained in all cases.
Conclusions
This real‐world case series suggest that chronic anticoagulant therapy alone should not automatically preclude the use of LA‐CAB + RPV. With careful patient selection and appropriate injection techniques, LA‐CAB + RPV may represent a safe and effective treatment option for selected people with HIV receiving anticoagulation.