Bictegravircontaining

Bictegravir-containing regimens are antiretroviral therapies that include the integrase strand transfer inhibitor bictegravir as part of a fixed-dose combination. The principal marketed bictegravir-containing regimen is Biktarvy, which combines bictegravir with emtricitabine and tenofovir alafenamide in a single oral tablet.

Bictegravir inhibits HIV-1 integrase, an enzyme required for integration of viral DNA into the host genome. By blocking integration, bictegravir prevents replication of the virus. When combined with the nucleoside reverse transcriptase inhibitors emtricitabine and tenofovir alafenamide, it provides a complete single-tablet regimen.

In adults and certain adolescents, bictegravir-containing regimens are used as initial therapy for HIV-1 infection and, for those already virologically suppressed, as switch therapy to maintain viral suppression. Biktarvy is taken once daily, with or without food. Because it contains tenofovir alafenamide, bone and kidney safety profiles differ from regimens containing tenofovir disoproxil fumarate; clinicians consider renal function and potential drug interactions when selecting therapy.

Resistance to bictegravir requires adherence to regimen; resistance can emerge with long-term nonadherence, and cross-resistance patterns with other INSTIs exist but may be limited. Common adverse events are generally mild and include diarrhea, nausea, or fatigue; serious adverse events are uncommon.

Dosing considerations include avoiding concomitant administration with polyvalent cations around the time of dosing to preserve absorption. Bictegravir-containing regimens are monitored with regular HIV-1 RNA testing and clinical tolerance as part of standard HIV care.