What is an example of Antiretroviral Therapy (ART) for a Human Immunodeficiency Virus (HIV) patient with viral suppression?

From the Guidelines

Dolutegravir/lamivudine is an example of Antiretroviral Therapy (ART) for a Human Immunodeficiency Virus (HIV) patient with viral suppression.

Key Points

• This regimen is recommended as an initial ART regimen 1 and can also be used for switching in patients with viral suppression 1.
• The recommended dosing for dolutegravir is 50mg once daily, and for lamivudine, it is 300mg once daily.
• Dolutegravir/lamivudine has demonstrated rates of viral suppression that were noninferior to the rates of viral suppression achieved with dolutegravir plus tenofovir disoproxil fumarate/emtricitabine 1.
• However, dolutegravir/lamivudine should not be started on the same day of HIV diagnosis, and HIV genotypic testing should confirm the absence of resistance to either of the 2 drugs before initiation 1.
• Additionally, patients with hepatitis B co-infection should not receive dolutegravir/lamivudine because lamivudine could select for hepatitis B virus resistance 1.
• Other options for ART in patients with viral suppression include dolutegravir/rilpivirine, a boosted PI with lamivudine, and long-acting injectable 2-drug regimens such as cabotegravir and rilpivirine 1.
• The choice of ART regimen should be individualized based on patient-specific factors, such as comorbidities, medication interactions, and patient preference 1.

From the Research

Antiretroviral Therapy (ART) for HIV Patients with Viral Suppression

• Examples of ART regimens for HIV patients with viral suppression include:
  • Ictegavir plus tenofovir alafenamide (TAF)/emtricitabine (FTC) 2
  • Dolutegravir (DTG) plus abacavir/lamivudine 2
  • Dolutegravir (DTG) plus TAF (or TDF)/FTC 2
  • Dolutegravir (DTG) plus 3TC 2
• Dual antiretroviral therapies, such as dolutegravir plus rilpivirine, have also been shown to be safe and efficacious as maintenance therapy for patients with viral suppression 3

Key Considerations

• ART regimens do not need to be altered for virologic blips due to release of virus from chronically latently infected cells in patients otherwise exhibiting viral suppression 2
• Patients with continuously undetectable viral load on ART pose virtually no risk of transmitting infection through sexual contact 2
• Adherence to ART is essential for achieving viral suppression, with studies suggesting that at least 90% adherence is necessary for effective management of HIV 4