Dolutegravirabacavirlamivudine

Dolutegravirabacavirlamivudine is a fixed-dose combination antiretroviral therapy used to treat HIV-1 infection. It contains three antiviral drugs—dolutegravir, abacavir, and lamivudine—delivered in a single tablet taken once daily, with or without food. The regimen is approved for adults and certain pediatric patients and is often used as a first-line option.

Dolutegravir is an integrase strand transfer inhibitor, while abacavir and lamivudine are nucleoside reverse transcriptase inhibitors. By combining agents with different targets, the regimen reduces viral replication and helps maintain treatment effectiveness while limiting resistance development.

Dosing and monitoring: The standard dose is one tablet daily, containing dolutegravir 50 mg, abacavir 600 mg, lamivudine 300 mg. Before initiation, testing for the HLA-B*57:01 allele is recommended to identify risk of abacavir hypersensitivity; abacavir-containing regimens should not be used in individuals who test positive. In people co-infected with hepatitis B, continuing HBV-active therapy is important, and switching must be managed to prevent HBV reactivation.

Safety and contraindications: Use is contraindicated in individuals with a known hypersensitivity to any component (especially abacavir). Dolutegravir exposure around conception has been associated with a small increased risk of neural tube defects in some data, so periconception use requires careful consideration. The tablet should be used with caution in renal impairment and with drugs that interact with integrase inhibitors or with lamivudine/abacavir, including certain polyvalent cations.

Adverse effects and notes: Common side effects include headache, nausea, and fatigue. Serious adverse events include hypersensitivity reactions to abacavir, lactic acidosis with hepatic steatosis, hepatotoxicity, and rare immune reconstitution inflammatory syndrome. It is marketed under the brand Triumeq by ViiV Healthcare and is listed in many national treatment guidelines as a preferred once-daily regimen for initial ART in appropriate adults.