Bictegravir vs. Dolutegravir for HIV Infection

Integrase inhibitor–based therapy is recommended as initial treatment for HIV-infected patients. Currently, the only single-tablet regimens that include both tenofovir and an integrase inhibitor also contain cobicistat, a pharmacologic booster that interacts with drugs metabolized by CYP3A4 and, therefore, is a potential disadvantage for patients who need such medications.

Now, investigators have conducted a randomized, phase II trial comparing first-line HIV treatment with bictegravir, a new HIV integrase inhibitor, versus dolutegravir each in combination with tenofovir alafenamide (TAF) and emtricitabine (FTC). Bictegravir and dolutegravir are unboosted integrase inhibitors that are active against HIV resistant to raltegravir or elvitegrav…