Two-Drug Regimens for HIV-Current Evidence, Research Gaps and Future Challenges

• Published in: Microorganisms (Basel) Vol. 10; no. 2; p. 433
• Main Authors: Pérez-González, Alexandre, Suárez-García, Inés, Ocampo, Antonio, Poveda, Eva
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.02.2022; MDPI
• Subjects: Acquired immune deficiency syndrome; AIDS; anti-retroviral treatment (ART); Antiretroviral agents; Antiretroviral therapy; Cardiovascular disease; Clinical trials; Drug interactions; Drug resistance; HIV; Human immunodeficiency virus; human immunodeficiency virus (HIV); Life expectancy; Life span; Non-nucleoside reverse transcriptase inhibitors; Nucleoside reverse transcriptase inhibitors; Nucleosides; Patients; Protease inhibitors; Proteinase inhibitors; Review; RNA-directed DNA polymerase; Side effects; three-drug regimen (3DR); Toxicity; two-drug regimen (2DR); anti-retroviral treatment (ART); three-drug regimen (3DR); human immunodeficiency virus (HIV); two-drug regimen (2DR)
• ISSN: 2076-2607; 2076-2607
• DOI: 10.3390/microorganisms10020433

During the last 30 years, antiretroviral treatment (ART) for human immunodeficiency virus (HIV) infection has been continuously evolving. Since 1996, three-drug regimens (3DR) have been standard-of-care for HIV treatment and are based on a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) plus two nucleoside reverse transcriptase inhibitors (NRTIs). The effectiveness of first-generation 3DRs allowed a dramatic increase in the life expectancy of HIV-infected patients, although it was associated with several side effects and ART-related toxicities. The development of novel two-drug regimens (2DRs) started in the mid-2000s in order to minimize side effects, reduce drug-drug interactions and improve treatment compliance. Several clinical trials compared 2DRs and 3DRs in treatment-naïve and treatment-experienced patients and showed the non-inferiority of 2DRs in terms of efficacy, which led to 2DRs being used as first-line treatment in several clinical scenarios, according to HIV clinical guidelines. In this review, we summarize the current evidence, research gaps and future prospects of 2DRs.