Vitekta (elvitegravir) / Japan Tobacco, Gilead - LARVOL DELTA

Evaluation of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide in Treatment-Naive Patients Living With Human Immunodeficiency Virus (HIV) With High Viral Load: A Retrospective Observational Study. (PubMed, Cureus) - "Although high pre-treatment viral load was associated with a transient delay in early viral suppression at month six, this did not appear to compromise longer-term treatment outcomes. These findings suggest that E/C/F/TAF may represent a useful treatment option, particularly in clinical settings where second-generation integrase inhibitors are restricted or unavailable."

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

National cross-sectional survey on acquired HIV drug resistance in Haiti in 2023: warnings resistance to dolutegravir (AIDS 2026) - "3.77% of HIVs were resistant to dolutegravir and bictegravir, 4.4% to cabotegravir, 4.72% to raltegravir, and 5.03% to elvitegravir. Additionally, 15.19% of the viral strains were resistant to abacavir, 13.92% to lamivudine and emtricitabine, 6.65% to zidovudine, 8.23% to stavudine and didanosine, and 4.13% to tenofovir...Furthermore, some HIVs strains developed resistance against efavirenz (49.37%), nevirapine (50%), Rilpivirine (20.25%), Etravirine (12.66%), and doravirine (3.61%). Finally, HIV genome resistance was 0.63% against atazanavir/ritonavir and indinavir/ritonavir, 0.95% against lopinavir/ritonavir and 0.32% against darunavir/ritonavir. HIV acquired pharmacoresistance is moderate in Haiti and requires innovating adapted strategy for preventing its development, its transmission, and for protecting PLHIV health, while emphasizing on children and male individuals."

Human Immunodeficiency Virus • Infectious Disease • Respiratory Diseases

Preclinical Pharmacokinetics of a Triple-Combination Intravaginal Ring for HIV Prevention. (PubMed, Pharmaceutics) - " We formulated two different triple-combination antiretroviral IVRs, both delivering the acid salt tenofovir (TFV), disoproxil fumarate (TDF), and the free base emtricitabine (FTC), with one delivering elvitegravir (EVG) as the free acid and the other as the sodium salt. TFV and FTC concentrations in rectal tissue and fluid suggested potential for dual-compartment HIV-1 protection, although the vaginal-to-rectal drug transport mechanism appeared to differ across both species. The humanized mouse vaginal HIV-1 efficacy model was used to empirically compare combination effects when TDF, FTC, and EVG were co-administered, and TDF-EVG was identified as a promising combination to be developed further for IVR delivery in parallel with the triple combination."

Journal • PK/PD data • Preclinical • Human Immunodeficiency Virus • Infectious Disease

Metabolic Mechanisms of INSTI-Associated Weight Gain: A Multi-Omics Study in Male People with HIV. (PubMed, J Infect Dis) - "Our integrated multi-omics approach reveals that INSTI-based regimens induce universal metabolic changes. The change of thyroxine and the predictability of TTR in multi-omic studies show the critical role of thyroxine metabolism in INSTI-associated weight gain."

Journal • Human Immunodeficiency Virus • Infectious Disease

Resistance profile of the HIV integrase strand transfer inhibitor GS-3242, a potent novel long-acting injectable INSTI in clinical development (AIDS 2026) - "BACKGROUND: The development of novel integrase strand transfer inhibitors (INSTIs) compatible with long-acting injectable lenacapavir dosing would provide an attractive treatment option for people with HIV-1 (PWH) who have challenges taking daily pills... GS-3242 retained potent activity, defined as an EC50 fold-change (FC) <2.5, against 71% of INSTI-resistant isolates tested, as compared to 82%, 62%, 53%, and 7% for bictegravir, dolutegravir, cabotegravir, and elvitegravir, respectively... GS-3242 exhibits a high resistance barrier and minimal cross-resistance within the INSTI class, a profile comparable to bictegravir. These observations support ongoing clinical evaluation of GS-3242 as a key component of a long-acting injectable treatment regimen for PWH."

Clinical • Human Immunodeficiency Virus • Infectious Disease

Deep sequencing unveils underestimated burden of integrase inhibitor resistance: a global individual participant data meta-analysis (AIDS 2026) - "BACKGROUND: Integrase strand transfer inhibitors (INSTIs), particularly second-generation agents like dolutegravir (DTG), are the cornerstone of global antiretroviral therapy (ART)...IPD analysis revealed that treated PLWH exhibited significantly elevated intermediate- to high-level resistance to first-generation agents (raltegravir/elvitegravir)... Conventional surveillance significantly underestimates the global burden of INSTI resistance by failing to detect low-frequency variants. This "hidden reservoir" of resistance (3.61% PDRMs and 2.46% ADRMs missed) poses a threat to the long-term success of INSTI-based programs, potentially facilitating the silent transmission of resistant strains and compromising long-acting regimens. Standardized deep sequencing surveillance is essential to accurately monitor evolving resistance patterns and guide clinical decision-making worldwide."

Retrospective data • Human Immunodeficiency Virus • Infectious Disease

HIV resistance to integrase strand-transfer inhibitors: a disproportionality analysis using the WHO global safety database (AIDS 2026) - " We carried out a disproportionality analysis to assess resistance to bictegravir, cabotegravir, dolutegravir, elvitegravir and raltegravir using the WHO global database of individual case safety reports (ICSRs), VigiBase®, as a data source. HIV resistance was differentially reported for the first- and second-generation INSTIs. The findings corroborate the WHO recommendations for continuous monitoring of HIV resistance to INSTIs, aiming to detect, control, and prevent this outcome, while expanding the use of this class of drugs."

Clinical • Human Immunodeficiency Virus • Infectious Disease

Antiproliferative effects of HIV integrase strand transfer inhibitors in experimental models for cancer research: A narrative review. (PubMed, J Pharmacol Exp Ther) - "Preclinical studies describe as INSTIs, including dolutegravir, raltegravir, cabotegravir, and elvitegravir and some 1,2,3-triazole derivatives, can inhibit the growth of various cancer cell lines and some of them seem to also have direct inhibitory effects on human endogenous retrovirus reactivation. SIGNIFICANCE STATEMENT: Currently, the effects of using integrase strand transfer inhibitors (INSTIs) on cancer development in people living with HIV are difficult to determine because of the multifactorial cause of cancer in these patients and the long period in which cancer manifests. This review examines the antiproliferative properties of INSTIs, describing the proposed mechanisms through which they may exert this effect in preclinical studies."

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

Integrase Inhibitors Impair Insulin Secretion by Disrupting Β-Cell Mitochondrial Function and Ca²⁺ Signaling (ENDO 2026) - "We therefore investigated how two commonly used INSTIs, Dolutegravir (DTG) and Elvitegravir (ELV) alter the signaling pathways that regulate insulin secretion in pancreatic β-cells. Our study indicates that DTG impaired mitochondrial ATP production and glucose-stimulated Ca2+ influx, leading to reduced insulin secretion under high-glucose conditions. These glucose dependent effects suggest that DTG-induced β-Cell dysfunction becomes apparent when metabolic demand is increased, such as in chronic hyperglycemia or insulin resistance, which could mechanistically explain the increased diabetes risk observed clinically in individuals starting DTG therapy. Further work should define the β-cell pathways affected by DTG and determine whether similar effects occur with other antiretroviral."

Diabetes • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders

Weight Gain on Contemporary Integrase Strand Transfer Inhibitors and Tenofovir Alafenamide in Persons with HIV Starting Antiretroviral Therapy in the United States and Canada. (PubMed, J Infect Dis) - "Weight gain with non-EFV NNRTIs was lower than with PIs and INSTIs, with the greatest increases observed among Black females starting TAF with contemporary INSTIs."

Journal • Human Immunodeficiency Virus • Infectious Disease

A robust pH-based second-order spectrophotometric method for the analysis of four anti-HIV drugs in pharmaceutical formulations. (PubMed, Sci Rep) - "A robust pH-based second-order spectrophotometric strategy combined with parallel factor analysis (PARAFAC) was developed for the simultaneous determination of elvitegravir (EVG), cobicistat (COBI), emtricitabine (FTC), and tenofovir disoproxil fumarate (TDF) in pharmaceutical formulations. The proposed strategy successfully preserved the second-order advantage, enabling reliable quantification in the presence of uncalibrated tablet excipients without prior separation. In addition to its satisfactory predictive capability, the method provides a simple, low-cost, and experimentally accessible alternative to chromatographic approaches for multicomponent pharmaceutical analysis."

Journal • Human Immunodeficiency Virus • Infectious Disease

Pharmacogenomics of current antiretroviral drugs. (PubMed, Pharmacogenomics) - "We searched Pharmacogenomics Knowledgebase (PharmGKB®) for abacavir, tenofovir disoproxil fumarate, tenofovir alafenamide, lamivudine, emtricitabine, dolutegravir, elvitegravir, raltegravir, bictegravir, cabotegravir, atazanavir/ritonavir, darunavir/ritonavir, lopinavir/ritonavir, lenacapavir, rilpivirine and doravirine. Actionable pharmacogenetic associations with antiretroviral drugs remain limited to abacavir. Future research should prioritize replicating pharmacogenetic associations across diverse populations and establishing clinical relevance."

Biomarker • Journal • Review • Human Immunodeficiency Virus • Infectious Disease • HLA-B • UGT1A1

Formulation Development of Topical Inserts Containing Doxycycline and Doxycycline Combined with Tenofovir Alafenamide and Elvitegravir for the Prevention of Sexually Transmitted Infections. (PubMed, AAPS PharmSciTech) - "These data describe the formulation development and in vitro characterization of topical inserts containing DOX alone or in combination with antiretrovirals (TAF and EVG). Both inserts offer a novel, on-demand topical STI prevention option that supports flexible PrEP/PEP use by both women and men."

Journal • Human Immunodeficiency Virus • Infectious Disease

Association between plasma concentrations of integrase strand transfer inhibitors and body weight gain in women living with HIV. (PubMed, AIDS) - "Higher RAL plasma concentrations were only modestly associated with percent body weight gain in WWH, unlike DTG or EVG. These findings do not suggest a consistent exposure-response relationship between INSTI concentrations and weight gain."

Journal • Human Immunodeficiency Virus • Infectious Disease

Synergistic antifungal activity of antiretrovirals with amphotericin B against Aspergillus species. (PubMed, PLoS One) - "From this hit set, we prioritized the two FDA-approved HIV drugs, cobicistat and elvitegravir, as promising lead candidates. These combinations also disrupted mature biofilms, achieving up to 80% eradication, a substantial improvement over AmB alone. These findings highlight the potential of these drug combinations as promising treatment options for aspergillosis, leveraging already approved therapies."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Prioritization of adverse events related to integrase inhibitors and NNRTIs: a disproportionality analysis using data from the FAERS database. (PubMed, J Antimicrob Chemother) - "This study provides a systematic framework for evaluating post-marketing AEs of INSTIs and NNRTIs using a semi-quantitative scoring system. Our findings identified five high-priority AEs that require clinical validation and further investigation."

Adverse events • Journal • Eosinophilia • Hematological Disorders • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Liver Failure

Pharmacovigilance study of INSTIs associated with weight gain and glucose/lipid metabolism adverse events based on the FDA adverse event reporting system. (PubMed, HIV Med) - "This study identified metabolic AEs associated with INSTIs, with agent-specific differences in risk and timing, highlighting the need for regular monitoring and individualized management during INSTI-based ART."

Adverse events • Journal • Dyslipidemia • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders

Longitudinal analysis of metabolic changes in people with HIV on integrase inhibitor-based versus efavirenz-based therapy: a prospective real-world cohort study in China. (PubMed, BMC Infect Dis) - "INSTI-based ART was associated with sustained weight gain but did not worsen long-term dyslipidemia compared to an EFV-based regimen in a real-world setting. Hepatic steatosis correlated with metabolic parameters rather than INSTI exposure."

Journal • Real-world evidence • Dyslipidemia • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders

Despite increasing use of integrase inhibitors to treat HIV infection, resistance to this class remains stable. (PubMed, J Antimicrob Chemother) - "Although the use of INSTIs has increased over time with differences in the duration of use, we did not observe a corresponding increase in the proportion of ARV-treated PLWHIV who experienced virological failure with INSTI-resistant viruses during the study period."

Journal • Human Immunodeficiency Virus • Infectious Disease

Partial post-exposure protection by topical inserts containing tenofovir alafenamide fumarate/elvitegravir in a macaque model of rectal SHIV infection. (PubMed, J Infect Dis) - "Here, we show that the same inserts provide significant post-exposure protection (82.9% efficacy) when applied four hours after SHIV exposure. Our findings further support the ongoing clinical development of TAF/EVG inserts for on-demand HIV prevention."

Journal • Human Immunodeficiency Virus • Infectious Disease

Deep sequencing reveals underestimated burden of integrase inhibitor resistance mutations in people living with HIV: a global individual patient data meta-analysis. (PubMed, Emerg Microbes Infect) - "IPD analysis of 394 mutation-positive individuals revealed 8.52% low-frequency resistance to dolutegravir and bictegravir in treatment-naïve populations, while treated patients exhibited significantly increased intermediate/high-level resistance to first-generation INSTIs, including raltegravir and elvitegravir. Although second-generation INSTIs maintain lower resistance rates, cross-resistance risks necessitate clinical vigilance. Optimized resistance surveillance strategies incorporating low-frequency mutation detection offer critical evidence for advancing global HIV control efforts."

Journal • Retrospective data • Human Immunodeficiency Virus • Infectious Disease

Curcumin-enhanced elvitegravir therapy mitigates neuroinflammation and cognitive deficits in EcoHIV mice. (PubMed, Exp Biol Med (Maywood)) - "These findings demonstrate that the EVG + CUR combination effectively targets both viral persistence and the underlying neuroinflammatory and oxidative mechanisms driving HAND. By improving cognitive and motor function while mitigating neuroinflammation and oxidative stress, EVG + CUR represents a promising adjunctive therapy for HAND, offering a multifaceted approach to addressing the complex pathophysiology of HIV-associated neurocognitive disorders."

Journal • Preclinical • CNS Disorders • Cognitive Disorders • Developmental Disorders • Human Immunodeficiency Virus • Infectious Disease • Inflammation • IL1B • IL6 • TNFA

Prevalence of primary HIV-1 drug resistance among antiretroviral-naïve individuals in Togo in 2023: a national study. (PubMed, Front Public Health) - "However, accessory mutations (genetic changes that do not confer significant resistance by themselves) as E157Q/E157EQ (43/57) and T97A/T97TA (14/57) associated with resistance against first-generation integrase inhibitors (INIs) as raltegravir, elvitegravir were found in 17.2% of samples. The dominant subtypes were CRF02_AG (64.8%) and CRF06_cpx (12.8%). These results support the continued use of dolutegravir-based regimens in Togo and call for continued monitoring of primary resistance to maintain the effectiveness of therapeutic strategies in Togo."

Journal • Human Immunodeficiency Virus • Infectious Disease

A Rare Case of Diffuse Esophageal Intramural Pseudodiverticulosis! (ACG 2025) - "Medications included a combination of elvitegravir, cobicistat, emtracitibine, and tenofovir alafenamide in addition to colchicine and atorvastatin. Management aims at controlling the underlying inflammation, relieving the patients' symptoms and treating the coexisting esophageal conditions. Despite that EIPD is considered a benign clinical entity, serious complications can occur including esophageal stricture, esophageal dysmotility, esophageal perforation, intra-mediastinal fistula, mediastinitis, and lung abscess.Figure: Esophageal Intramural Pseudo-DiverticulosisFigure: Pathology"

Clinical • Candidiasis • CNS Disorders • Depression • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Gout • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Inflammatory Arthritis • Psychiatry • Rheumatology • CD4

Integrase Strand Transfer Inhibitors for Treatment-experienced Young Adults With Perinatal HIV in the US: Immunologic, Virologic, and Anthropometric Outcomes. (PubMed, Clin Infect Dis) - "Individual INSTI-based regimens among treatment-experienced AYAPHIV had moderate effectiveness with respect to viral suppression. Continued average weight gain across INSTIs raises concerns about long-term cardiometabolic sequalae."

Journal • Human Immunodeficiency Virus • Infectious Disease • Obesity • Pediatrics • CD4