Dynamic changes of monocytes-related immune activation in people with HIV switching to long-acting injectable cabotegravir plus rilpivirine

Abstract The aim of this study was to examine the dynamic changes in monocyte/macrophage- and dendritic cell (DC)-related immune activation in people with HIV (PWH) before switching to long-acting (LA) injectable cabotegravir (CAB) plus rilpivirine (RPV) (T0), after six (T6m) and twelve months (T12m). A total of 30 aviremic PWH switching to LA CAB plus RPV, and 32 healthy donors (HDs) were enrolled. At each time point, in comparison to HDs, PWH exhibited higher classical and intermediate monocyte counts and lower slanDC and pDC counts. Compared to HDs, in PWH non-classical monocyte counts were higher only at T0. PWH exhibited elevated sCD163 and sCD14 plasmatic levels at each time point, in comparison to HDs. No virological failure was observed. At T12m, no differences in the total cell-associated HIV-1 DNA levels compared to T0 were found. The longitudinal evaluation showed a significant reduction in non-classical and intermediate monocyte counts at T12m compared to T0 and an increase in classical monocyte and pDC counts. Furthermore, a reduction in sCD14 plasma levels was observed. The constant drug concentrations provided by CAB plus RPV injections appear to be effective for a sustained and deep virological suppression that may reduce monocyte/macrophage activation in PWH.