2DR Debate: Should the Majority of People Living with HIV Be on a 2DR Regimen?

About this Program

Currently, most of the treatment guidelines are dominated by three-drug combination ART with two drug combinations starting to be recognized as a preferred therapy in naïve patients.

However, two drug strategies including those of newer compounds and formulations (single pills/injections) are beginning to be used extensively in people who switch because of simplification, side effects, or potential drug interactions, in some patients with prior failure and resistance and even as an option in the rapid start strategy.

Multiple clinical studies have shown that HIV treatment with a two-drug (2DR) combination is non-inferior to the three-drug combination in start and switch studies e.g the Gemini-1, Gemini-2 in Naïve; DTG/3TC was non-inferior to DTG + tenofovir/emtricitabine (1). Tango and Salsa trials proved that switching to or maintaining (DTG/3TC) was virologically non-inferior to maintaining a 3- or 4-drug regimen including tenofovir alafenamide (TAF) through 144 weeks (2,3). Sword (DTG/RPV) showed efficacy and safety data for switching to DTG/RPV for 1st line and 2nd line ART therapies (4).

Making the medical community more aware of this 2DR concept and showing the opportunities in various treatment situations but also the limitations, it’s important to discuss the pros and cons of this new strategy.

This debate led to an improved understanding of the two-drug concept and will enable the prescribers to make well-considered decisions on selecting the most optimal treatment option for their patients.

The interactive quiz element was used to discuss the clinical data and will allow the participants to improve their knowledge.

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