Journal of Infectious Diseases & Therapy
Open Access

Abstract

Current antiretroviral therapy (ART) effectively suppresses HIV replication. However, standard ART combinations still
posse’s enormous challenges in clinical practice. In this context, research on simplified therapies has emerged to fill the
gap. The main advantages of simplified regimens include: reduce pill burden, improve patient compliance and avoid longterm
toxicity while preserving future treatment options and maintaining virological efficacy. There has been interest in the
combination of lamivudine (3TC) and boosted protease inhibitor (bPI) for treatment of HIV infection, because 3TC is well
tolerated, widely available and relatively cheap. We aim to examine studies including dual therapy with 3TC + bPI in adults
HIV-positive patients with varying degrees of ART experience. We retrieved published English language studies via PubMed,
Medline and Google Scholar through March 2015. Our search terms included “HIV”, “treatment simplification” and “dual
therapy”. Our research yielded 80 hits, and 7 titles were fully reviewed. The remaining articles were excluded as they evaluated
other simplified dual therapy regimens (i.e. Maraviroc + Darunavir/ritonavir; Raltegravir + Lopinavir/ritonavir, Etravirine
+ Raltegravir). Lopinavir/r + 3TC was the most frequent combination (3 studies), followed by Atazanavir/r (2 studies) and
Darunavir/r (2 studies). We found that in ART-naïve patients, there now exists a robust evidence for the use of 3TC plus
PI/r dual therapy. In treatment–experienced virologically suppressed patients switching to dual therapy, evidence is sparse
and largely driven by small observational or pilot studies. Overall, the evidence suggests that selection of right candidate for
dual therapy is critical in the consolidation of this simplified strategy as an accepted HIV treatment approach. Fully powered
randomized trials are eminent needed to proper define the place of this simplified regimen in international HIV treatment
guidelines.
Support: Moreira JAS was supported by a scholarship from “Programa de Estudantes - Convênio de Pós-graduação – PEC-PG,
da CAPES/CNPQ – Brazil”.

Biography

Jose Alfredo de Sousa Moreira has completed his medical specialization in infectious diseases from Evandro Chagas National Institute of Infectious Diseases (INI/
FIOCRUZ). He is currently a first-year master student working on an interdisciplinary research between INI/FIOCRUZ and Mozambique National Institute of Health.
Supervised by Prof. Valdilea Veloso (Co-chair of INI/FIOCRUZ clinical research laboratory on HIV/AIDS). His research is sponsored by PEC-PG, Brazil. He has
published more than 8 papers in reputed journals and has been serving as a reviewer board member of HIV and infectious diseases journals.