Gynoid Fat Distribution and Adipocyte Trapping May Explain Virological Failure With Intramuscular Long-Acting Cabotegravir and Rilpivirine

Isabelle de Malliard; Anne-Laure Houist; Gilles Peytavin; Thomas L'Yavanc; Magali Bouvier; Pierre Cappy; Jean-Daniel Lelièvre; Elsa Feredj; William Vindrios; Sebastien Gallien; Giovanna Melica

doi:10.1093/ofid/ofad217

Gynoid Fat Distribution and Adipocyte Trapping May Explain Virological Failure With Intramuscular Long-Acting Cabotegravir and Rilpivirine

Open Forum Infect Dis. 2023 May 2;10(5):ofad217. doi: 10.1093/ofid/ofad217. eCollection 2023 May.

Authors

Affiliations

¹ Department of Clinical Immunology and Infectious Diseases, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.
² Infection Antimicrobials Modelling Evolution, Inserm, Université de Paris, Paris, France.
³ Laboratoire de Pharmacologie-Toxicologie, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat Claude Bernard, Paris, France.
⁴ Posthospitalization and Rehabilitation Unit, Hôpital Jean Jaurés, Paris, France.
⁵ Department of Virology, Henri Mondor Hospital, Créteil, France.
⁶ Vaccine Research Institut, Inserm U955 Equipe 16, Université Paris Est Créteil, Créteil, France.

Abstract

Intramuscular long-acting antiretroviral drugs can improve adherence to lifelong antiretroviral treatment. Nevertheless, adipose tissue thickness and distribution play a critical role with injectable drugs. We describe a virological failure with cabotegravir and rilpivirine in a Black African woman with human immunodeficiency virus type 1 with gynoid fat distribution (ie, adipose tissue prevailing in the pelvis and hip area) and body mass index <30 kg/m².

Keywords: HIV infection; adipocyte trapping; gynecoid fat distribution; intramuscular long-acting antiretroviral drugs; virological failure.