Optimizing Antiretroviral Therapy with Bictegravir/Emtricitabine/Tenofovir Alafenamide in virologically suppressed PLWH.

Abstract

The pillar of treatment success, defined as viral suppression and immune restoration, should be integrated into a modern vision of therapeutic success with pharmacological attributes of ART, such as potency, forgiveness, and genetic barrier of single drugs and regimens, as well as their longterm tolerability and safety. Moreover, the longterm success of lifelong treatment cannot be separated from the opinions and preferences of PLWH. Regimen Optimization in the setting of HIV suppression may reduce pill burden, and/or dosing frequency, enhance tolerability and/or decrease toxicity, prevent or mitigate DDIs, eliminate food/fluid requirements, relieve pill fatigue, decrease stigma or concerns associated with taking oral med, allow pregnancy, reduce costs (DHHS 2023). Regimen Optimization should be tailored by a person-centered perspective, based on the individual therapeutic history, past toxicities and comorbidities. The treatment strategy should be based on the perceived tolerability and quality of life, considering the preferences of people on treatment along with the virological and pharmacological factors. The health care system should facilitate universal and rapid access to personalized, robust, and effective therapies. The BIC/FTC/TAF association ensures all these characteristics and therefore represents a valid strategy for optimizing treatment in PLWH virologically suppressed.