Two-drug regimens for HIV treatment

Kevin M. Gibas, Sean G. Kelly, Jose R. Arribas, Pedro Cahn, Chloe Orkin, Eric S. Daar, Paul E. Sax, Babafemi O. Taiwo*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


Combination therapy with three antiretroviral agents has been integral to successful HIV-1 treatment since 1996. Although the efficacy, adverse effects, and toxicities of contemporary three-drug regimens have improved, even the newest therapies have potential adverse effects. The use of two-drug regimens is one way to reduce lifetime exposure to antiretroviral drugs while maintaining the benefits of viral suppression. Multiple large, randomised trials have shown the virological non-inferiority of certain two-drug regimens versus three-drug comparators, including adverse effect differences that reflect known profiles of the antiretroviral drugs in the respective regimens. Two-drug combinations are now recommended in treatment guidelines and include the first long-acting antiretroviral regimen for the treatment of HIV-1. Recommended two-drug regimens differ in their risks for, and factors associated with, virological failure and emergent resistance. The tolerability, safety, metabolic profiles, and drug interactions of two-drug regimens also vary by the constituent drugs. No current two-drug regimen is recommended for people with chronic hepatitis B virus as none include tenofovir. Two-drug regimens have increased options for individualised care.

Original languageEnglish (US)
Pages (from-to)e868-e883
JournalThe Lancet HIV
Issue number12
StatePublished - Dec 2022

ASJC Scopus subject areas

  • Infectious Diseases
  • Epidemiology
  • Virology
  • Immunology


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