Juluca (dolutegravir/rilpivirine) / ViiV Healthcare, J&J - LARVOL DELTA

Narrative Review of Two-Drug Regimens in Modern HIV Care: Driving Innovation, Flexibility, and Quality of Life. (PubMed, Infect Dis Ther) - "Dolutegravir/lamivudine, dolutegravir/rilpivirine and long-acting cabotegravir/rilpivirine are the regimens studied the most, supported by randomised trials and real-world evidence. Long-acting injectable strategies may be particularly valuable for individuals who face challenges with daily oral adherence or treatment-related stigma. This narrative review summarizes current evidence on the role of oral and injectable 2DRs in key domains including innovation, flexibility, tolerability, adherence and quality of life, while discussing current limitations and future perspectives."

HEOR • Journal • Review • Human Immunodeficiency Virus • Infectious Disease

Virological reactivation of the hepatitis B virus after simplification of antiretroviral treatment. (PubMed, Enferm Infecc Microbiol Clin (Engl Ed)) - "ART simplification without HBV-active agents may be associated with HBV DNA reappearance in patients with prior exposure. The clinical significance of low-level viremia remains uncertain, and further studies are needed."

Journal • Hepatitis B • Human Immunodeficiency Virus • Infectious Disease • Inflammation

Nanoemulsion-based transdermal delivery of rilpivirine and dolutegravir for pediatric HIV treatment. (PubMed, Int J Pharm) - "Finally, permeation studies demonstrated that this formulation enables a sustained delivery of both drugs through the skin for 24 h. In conclusion, the developed nanoemulsion formulation represents a promising alternative for pediatric HIV therapy, with the potential to improve treatment outcomes."

Journal • Gastrointestinal Disorder • Human Immunodeficiency Virus • Infectious Disease • Pediatrics

Durability of dolutegravir/rilpivirine in the presence of K103N: refining treatment simplification. (PubMed, AIDS) - No abstract available

Journal

Risk of Developing Low-Level Viral Rebound Among People With HIV Receiving 2- or 3-Drug Regimens: A Case-Control Study Nested in the ICONA Cohort. (PubMed, Open Forum Infect Dis) - "The cumulative incidence of LLVR after virological suppression was estimated using Kaplan-Meier methods, and conditional logistic regression models were used to evaluate the association between the current antiretroviral therapy regimen (2DR [dolutegravir/lamivudine, dolutegravir/rilpivirine, dolutegravir/doravirine, or cabotegravir/rilpivirine] vs 3DR [dolutegravir, bictegravir, rilpivirine, doravirine, boosted darunavir, or boosted atazanavir-based with a backbone of tenofovir and lamivudine or emtricitabine]) and LLVR risk. After adjusting for confounding, evidence for an association with current regimen was inconclusive (adjusted odds ratio, 0.86 [95% CI, .57-1.29]). Despite the wide range of plausibility, we can exclude a risk of LLVR higher than 29% when using 2DR versus 3DR regimens."

Clinical • Journal • Human Immunodeficiency Virus • Infectious Disease • CD4

Renal and Cardiovascular Complications Following Type 2 Diabetes Mellitus in People With and Without HIV: Data from Cohort Study on Morbidity and HIV in Sweden (COSMOHS) between 2010-2024. (PubMed, Clin Infect Dis) - "In this nationwide cohort, PWH with T2DM exhibited higher risk of renal complications than PWoH, indicating enhanced renal monitoring may be warranted. Further research should investigate underlying mechanisms, including antiretroviral therapy, to guide clinical management."

Journal • Cardiovascular • Diabetes • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Type 2 Diabetes Mellitus

Changes in sleep quality following a switch of antiretroviral regimen from three to two drugs: a comparative study between dolutegravir/lamivudine (DTG+3TC) and dolutegravir/rilpivirine (DTG+RPV) (ESCMID Global 2026) - No abstract available

Gene Therapies • Human Immunodeficiency Virus • Infectious Disease

Real-world use of second-generation integrase strand transfer inhibitors (INSTI) as switch therapy in the prospective ANRS-CO3-AquiVIH-NA cohort. (PubMed, HIV Med) - "In this real-world cohort, treatment persistence 18 months after therapy switch was similar for B/F/TAF, DTG/RPV and DTG/3TC, but significantly lower for DTG/3TC/ABC. All regimens maintained high levels of viral suppression. Furthermore, the cohort illustrates the disease burden experienced by middle-aged and elderly people living with HIV and highlights the importance of adapting ART to the specific needs of this population."

Journal • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Diabetes • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Metabolic Disorders • Nephrology • Renal Disease

What Are the Causes and Consequences of Virological Failure on Long-acting Cabotegravir/Rilpivirine? (PubMed, Clin Infect Dis) - No abstract available

Journal • Human Immunodeficiency Virus • Infectious Disease

Durable efficacy of dolutegravir/rilpivirine switch in subjects with HIV RNA <50 copies/mL and history of K103N mutation. (PubMed, AIDS) - "Week 96 data confirm that switching to DTG/RPV maintains virological suppression and is safe in most participants with a history of K103N."

Journal • Human Immunodeficiency Virus • Infectious Disease

Effectiveness and safety of two-drug regimens containing an integrase inhibitor and reverse transcriptase inhibitor in a cohort of virologically suppressed people with HIV: Data from the COMBINE-2 study. (PubMed, HIV Med) - "Among suppressed people living with HIV in a real-world setting, INSTI+RTI two-drug regimens were highly effective and well tolerated over 96 weeks of follow-up."

Journal • Human Immunodeficiency Virus • Infectious Disease

A Case Report on Lactic Acidosis Induced by Biktarvy in a Patient With Renal Impairment: A Rare Complication of Antiretroviral Therapy. (PubMed, J Int Assoc Provid AIDS Care) - "Biktarvy, a once-daily combination of bictegravir, emtricitabine, and tenofovir alafenamide (TAF), is a highly effective antiretroviral therapy for HIV management. Upon discharge, lactate and creatinine returned to baseline. At outpatient follow-up, he remained clinically stable on Dolutegravir-Rilpivirine and Entecavir."

Journal • Chronic Kidney Disease • Hepatitis B • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Metabolic Disorders • Nephrology • Pneumonia • Renal Disease • Respiratory Diseases

A Quality Improvement Pilot to Increase Hepatitis B Screening and Optimize Patient Selection for the Switch to Two-Drug Antiretroviral Regimens in People With HIV. (PubMed, Open Forum Infect Dis) - "An EHR best practice advisory was linked to 2DR orders (dolutegravir-lamivudine, dolutegravir-rilpivirine, cabotegravir-rilpivirine) reminding clinicians to check HBV serologies prior to the switch and providing guidance for prescribing 2DRs to reduce risk of HBV reactivation in people with HIV. In this study, an EHR-based intervention increased HBV screening rates and decreased switches in those at highest risk of HBV reactivation (positive HBsAg or isolated positive HBcAb). With the increasing uptake of 2DRs, optimizing patient selection is vital to prevent HBV reactivation."

Journal • Hepatitis B • Human Immunodeficiency Virus • Infectious Disease • Inflammation

A case series of acute hepatitis B among PLWH switched to long acting (LA) Cabotegravir (CAB)/ Rilpivirine (RPV) (EACS 2025) - "Method : In this retrospective study, we enrolled PLWH without HBV coinfection (negative AgHbs)(5 HIV French centers;n= 16,550) who initiated LA CAB/RPV between January2022 and December2024...ART regimens before LA switch included tenofovir(TDF) for all patients except for one who was on DTG/RPV during 3months after a previous withdrawal of TDF...Anti-HBV therapy was reintroduced for 6 patients (TDForTAF(5),entecavir(1)).All patients reached HBV pVL<10UI/mL in the six following months the HBV infection. Conclusions : We alert on the need to ensure HBV coverage (either with protective titers of anti-HBs Abs or with continuation of anti-HBV therapy),before withdrawal of TDF from ART strategies among PLWH."

Clinical • Hepatitis B • Human Immunodeficiency Virus • Infectious Disease

Comparable efficacy but greater discontinuations due to adverse events with dolutegravir-containing two-drug versus three-drug antiretroviral therapy: a systematic review and meta-analysis (EACS 2025) - "We assessed three prespecified subgroups: dolutegravir/lamivudine (DTG/3TC); dolutegravir/rilpivirine (DTG/RPV) and dolutegravir/ritonavir-boosted-darunavir (DTG/DRV/r). There were more discontinuations due to AEs with 2DR. However, the effect of switch studies may have contributed to this."

Adverse events • Retrospective data • Review • Human Immunodeficiency Virus • Infectious Disease • CD4

Risk of virological rebound is similar in people with HIV switching to long-acting cabotegravir/rilpivirine or integrase inhibitor-based oral therapy (EACS 2025) - "Method : Observational study on PWH on virological suppression who switched to CAB/RPV enrolled in the SCohoLART study or to INSTI-based oral therapy (DGT/3TC, DTG/RPV, B/F/TAF) from July 2022 to April 2025. PWH with a longer viral suppression time [HR 0.703 (0.57-0.87) p=0.0012] were less likely to experience blips and VFs (Figure 1) (Table 2). Conclusions : Risk of virological rebound was comparable in PWH switching to CAB/RPV or an INSTI-based oral regimen; longer duration of virological suppression before switching is associated with a lower risk of viral rebound."

Human Immunodeficiency Virus • Infectious Disease • CD4

Risk of virological failure after switch to a tenofovir-sparing dual therapy in virologically suppressed people with HIV and past HBV infection (EACS 2025) - "PWH starting a TFV-sparing DT (3TC+bPI or DTG, DTG+RPV, DOR+DTG or long-acting CAB+RPV) were considered in the “treatment”-group only if they switched within a predefined “grace” period of 2 years...DT didn't predict VF (vs TT, aHR: 0.96, 95% CI 0.67-1.37; p=0.812), that was conversely associated with HBsAb+ serostatus (vs HBsAb-, aHR: 0.64, 95% CI 0.48-0.86; p=0.003). Conclusions : Switch to a TFV-sparing DT did not predict VF in PWH and prior HBV infection."

Hepatitis B • Human Immunodeficiency Virus • Infectious Disease

Patient-Reported Health and Virological Outcomes Among People with HIV Switching to Long-Acting Injectable Cabotegravir and Rilpivirine (LANTERN) (EACS 2025) - "Antiretroviral therpy regimens before switching included BIC/FTC/TAF (n=37, 27.1%), DTG/3TC (n=65, 47.4%), DTG/RPV (n=6, 4.4%), TAF/FTC/RPV (n=28, 20.4%) and DTG/3TC/ABC (n=1, 0.7%). Conclusions : Switching to CAB plus RPV LA was associated with improved treatment satisfaction and high acceptance, alongside high rates of virological suppression, with no individuals experiencing virological failure during the observation period. In conclusion, this study suggests that CAB plus RPV LA may be a beneficial treatment option in Taiwan."

Clinical • Human Immunodeficiency Virus • Infectious Disease

Long-acting injectable cabotegravir and rilpivirine outcomes in HIV individuals with stable treatment with dolutegravir and rilpivirine (EACS 2025) - "The virological failure was very low in both groups (table 2) Conclusions : In real life settings, the switch from DTG+RPV to CAB+RPV is safe and well tolerated. It is not essential the genotype nor the subtype if the VL is undetectable."

Clinical • Hepatitis B • Human Immunodeficiency Virus • Infectious Disease

High Uptake of Intermittent Drug-Reduced ART Strategies Among Virally Suppressed People Living with HIV (PWH) at an HIV Clinic in Paris, France (EACS 2025) - "The main intermittent ART regimens were TAF/FTC/RPV (18.6%) and TAF/FTC/BIC (11.7%) for 3-DR-I, and DTG/RPV (4.8%) and DTG/3TC (3.1%) for 2-DR-I. Conclusions : Over 8 years, intermittent therapy was selected in 25% of PWH with suppressed viremia. This highly effective and cost-saving approach should be considered in Europe."

Human Immunodeficiency Virus • Infectious Disease

Durability and reasons for treatment discontinuation of BIC/FTC/TAF in real life: data from 927 Persons With HIV in charge to “D. Cotugno” hospital, Naples, Southern Italy (EACS 2025) - "Most common post-TD treatments were LA-Cabotegravir+LA-Rilpivirine and Dolutegravir/Lamivudine...Post-TD regimens varied significantly by discontinuation reason: DTG/3TC, LA RPV+LA CAB, DRV/c/FTC/TAF, FTC/TDF+RAL 1200mg, and DRV/c/FTC/TAF again were the regimens most used in case of switch for Simplification/proactive switch, Patients’ choice, Toxicity, Pregnancy, and Virologic failure, respectively. Conclusions : B/F/T shows excellent real-life durability, with a low TD rate. When discontinuation occurs, it is mostly due to physician-driven proactive strategies or PWH-driven decisions rather than efficacy or tolerability issues."

Clinical • Human Immunodeficiency Virus • Infectious Disease

A combined dolutegravir–rilpivirine oral regimen as lead-in therapy for long-acting injectable antiretroviral treatment in people living with HIV (EACS 2025) - "Purpose : Long-acting injectable cabotegravir and rilpivirine (LA CAB/RPV) simplifies HIV-1 maintenance therapy. No systemic toxicity including neurologic effects, was reported. Conclusions : Oral DTG/RPV appears to be a suitable alternative to standard oral CAB/RPV lead-in, before initiation of long-acting injectable therapy."

Human Immunodeficiency Virus • Infectious Disease • CD4

Differential expression of ER-TR7 following challenge with more recent antiretroviral drugs: an in vitro model (EACS 2025) - "Results : Cells expressed ER-TR7 with a different degree of expression, being CAB, DOR and the associations CAB/RPV and DTG/RPV able to express higher levels of ER-TR7 compared to RPV and to the association DTG/DOR that displayed moderate expression levels and to the containing TAF and TDF regimens that expressed this marker at a level comparable to control...Conclusions : This data highlights that in vitro challenge of 3T3-L1 cells with newer INSTIs and NNRTIs differently modulated ER-TR7 expression levels driving a number of these cells toward the expression of some morphological changes. This result, considering the potential role of this phenomenon on metabolic pathways, needs further studies to explore potential clinical implications."

Preclinical • Infectious Disease • ER

Clinical outcomes on B/F/TAF and dolutegravir-based regimens at 12 months following regimen switch: an observational cohort study. (PubMed, AIDS Res Ther) - "Despite differences in baseline characteristics and regimen adherence between individuals switched to B/F/TAF, DTG STRs, and MTRs, both B/F/TAF and DTG-based regimens were associated with high rates of virologic suppression. This data strongly supports the inclusion of these simple and safe regimens as switch options in virologically suppressed PWH. Baseline differences in patient demographics and characteristics may have impacted the adherence on B/F/TAF compared to DTG STR, however virologic outcomes were preserved, demonstrating the forgiveness of B/F/TAF in populations potentially facing adherence challenges."

Clinical data • Journal • Observational data • Retrospective data • Cardiovascular • Human Immunodeficiency Virus • Infectious Disease • CD4

Risk of clinical events in virologically suppressed people with HIV switching to a two-drug regimen vs. remaining on a three-drug regimen: a target trial emulation. (PubMed, EClinicalMedicine) - "PWH were classified according to therapeutic strategies: switching to 2DR (protease inhibitors or dolutegravir plus lamivudine or dolutegravir plus rilpivirine) or remaining on 3DR (any combination). This study provides evidence that virologically suppressed PWH can be safely switched to 2DR, and may slightly reduce the 3-year risk of a composite clinical outcome. The Icona Foundation Study is supported by unrestricted grants from Gilead Sciences, ViiV Healthcare, Merck Sharpe & Dohme."

Clinical • Journal • Cardiovascular • Human Immunodeficiency Virus • Infectious Disease • Oncology