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Review
. 2018 Nov 1:12:3731-3740.
doi: 10.2147/DDDT.S140767. eCollection 2018.

Two-drug regimens for treatment of naïve HIV-1 infection and as maintenance therapy

Katya C Corado  1 , Margaret R Caplan  1 , Eric S Daar  1
Affiliations
Review

Two-drug regimens for treatment of naïve HIV-1 infection and as maintenance therapy

Katya C Corado et al. Drug Des Devel Ther. .

Abstract

As people live longer with HIV infection, there has been a resurgence of interest in challenging the use of three-drug therapy, including two nucleoside reverse transcriptase inhibitors plus a third drug, as initial treatment of HIV infection or for maintenance therapy in virologically suppressed individuals. Although initial studies showed poor efficacy and/or substantial toxicity, more recent regimens have held greater promise. The SWORD-1 and -2 studies were pivotal trials of dolutegravir plus rilpivirine as maintenance therapy in virologically suppressed patients with no history of drug resistance, leading to the US Food and Drug Administration's approval of the regimen as a small, single tablet. More recently, the GEMINI-1 and -2 studies demonstrated that dolutegravir plus lamivudine is as safe and effective as the same regimen when combined with tenofovir disoproxil fumarate in treatment-naïve individuals. Together, these and other studies of novel two-drug regimens offer the potential for improved tolerability and simplicity, as well as a reduction in cost. We will review historical and recent trials of two-drug therapy for the treatment of HIV-1 infection.

Keywords: HIV-1 infection; initial therapy; maintenance therapy; treatment strategies; two-drug therapy.

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Conflict of interest statement

Disclosure KC Corado has received research support from Gilead Sciences. MR Caplan has received research support from Gilead Sciences. ES Daar has received research support from Gilead Sciences, Merck & Co., and ViiV Healthcare. He has also acted as a consultant for Gilead Sciences, Merck & Co., ViiV Healthcare, and Theratechnologies. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

References

    1. US Department of Health and Human Services [webpage on the Inter-net] FDA approval of HIV medicines. 2018. [Accessed July 18, 2018]. Available from: https://aidsinfo.nih.gov/understanding-hiv-aids/infographics/25/fda-appr....
    1. Antonelli G, Turriziani O, Verri A, et al. Long-term exposure to zidovudine affects in vitro and in vivo the efficiency of phosphorylation of thymidine kinase. AIDS Res Hum Retroviruses. 1996;12(3):223–228. - PubMed
    1. Gröschel B, Cinatl J, Cinatl J. Viral and cellular factors for resistance against antiretroviral agents. Intervirology. 1997;40(5–6):400–407. - PubMed
    1. Chariot P, Drogou I, de Lacroix-Szmania I, et al. Zidovudine-induced mitochondrial disorder with massive liver steatosis, myopathy, lactic acidosis, and mitochondrial DNA depletion. J Hepatol. 1999;30(1):156–160. - PubMed
    1. Chiao SK, Romero DL, Johnson DE. Current HIV therapeutics: mechanistic and chemical determinants of toxicity. Curr Opin Drug Discov Devel. 2009;12(1):53–60. - PubMed

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