What are the DHHS ART recommendations for antiretroviral therapy regimens in HIV treatment naïve patients?

Updated: Apr 18, 2019
  • Author: R Chris Rathbun, PharmD, BCPS (AQ-ID), AAHIVP; Chief Editor: John Bartlett, MD  more...
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Answer

Answer

Table 1. Recommended Regimens for Most ART-Naive Patients (Open Table in a new window)

Integrase Component

Nucleoside Backbone

Bictegravir

Tenofovir + Emtricitabine a,b

Dolutegravir

Elvitegravir/Cobicistat

Raltegravirc

Dolutegravir

Abacavird + Lamivudine

a – lamivudine may be substituted for emtricitabine or vice versa

b – tenofovir component can be either tenofovir disoproxil fumarate (DF) or tenofovir alafenamide (AF) (both agents have an AI or AII rating)

c – raltegravir can be dosed 400 mg twice daily or 1200 mg once daily (utilizing the 600 mg formulation)

d – only for patients who are HLA-B*5701 negative

 

Table 2. Recommended Regimens for Certain Clinical Situations (Open Table in a new window)

Protease Inhibitor

Nucleoside Backbone

Darunavir/Ritonavir or Darunavir/Cobicistat

Or

Atazanavir/Ritonavir or Atazanavir/Cobicistat

Tenofovir + Emtricitabinea,b

Or

Abacavirc + Emtricitabinea

Non-Nucleoside Reverse Transcriptase Inhibitor

 

Efavirenz

Or

Rilpivirined

Tenofovir + Emtricitabinea,b

Integrase Strand-Transfer Inhibitore

 

Raltegravirf

Abacavirc + Emtricitabinea

a – lamivudine (3TC) may be substituted for emtricitabine (FTC) or vice versa

b – tenofovir component can be either tenofovir disoproxil fumarate (DF) or tenofovir alafenamide (AF) (both agent have an AI or AII rating)

c – only for patients who are HLA-B*5701 negative

d – only if HIV RNA < 100,000 copies/mL and CD4 >200 cells/mm3

e – only if HIV RNA < 100,000 copies/mL and HLA-B*5701 negative

f - raltegravir can be dosed 400 mg twice daily or 1200 mg once daily (utilizing the 600 mg formulation)


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