4
Selecting a Treatment Regimen
Table 3. Antiretroviral Regimens for Antiretroviral Therapy–
Naive Patients (Updated October 2013)
Initiate therapy with 1 of the following 3 types of regimen:
Î NNRTI + 2 NRTIs OR
Î PI (preferably boosted with RTV) + 2 NRTIs OR
Î INSTI + 2 NRTIs
• Selection of a regimen should be individualized based on virologic efficacy, toxicity, pill burden, dosing
frequency, drug-drug interaction potential, resistance testing results, and comorbid conditions.
• Based on individual patient characteristics and needs, in some instances, an alternative regimen
may actually be a preferred regimen for a patient.
Preferred Regimens
(Regimens with optimal and durable efficacy, favorable tolerability and toxicity profile, and ease of use.)
e preferred regimens for non-pregnant patients are arranged by order of FDA approval of
components other than nucleosides, thus, by duration of clinical experience.
NNRTI-Based Regimen
Î EFV
a
/TDF/FTC
b
(AI)
PI-Based Regimens
(alphabetical order)
Î ATV/r
c
+ TDF/FTC
b
(AI)
Î DRV/r (daily) + TDF/FTC
b
(AI)
INSTI-Based Regimens
(in order of drug approval)
Î RAL + TDF/FTC
b
(AI)
Î FTC/TDF/EVG/COBI
b,f
(AI)
Î DTG + ABC/3TC
n
(AI)
Î DTG + TDF/FTC (AI)
Alternative Regimens
(Regimens that are effective and tolerable but have potential disadvantages compared with preferred
regimens. An alternative regimen may be the preferred regimen for some patients.)
NNRTI-Based Regimens
(alphabetical order)
Î EFV
a
+ ABC
d
/3TC
b
(BI)
Î RPV
g
/TDF/FTC
b
(BI)
Î RPV
g
+ ABC
d
/3TC
b
(BIII)
PI-Based Regimens
(alphabetical order)
Î ATV/r
c
+ ABC
d
/3TC
b
(BI)
Î DRV/r + ABC
d
/3TC
b
(BIII)
Î FPV/r (daily or bid) + (ABC
d
/3TC
b
or TDF/FTC
b
) (BI)
Î LPV/r
h
(daily or bid) + (ABC
d
/3TC
b
or TDF/FTC
b
) (BI)
Acceptable Regimens
(Regimens that may be selected for some patients but are less satisfactory than preferred or
alternative regimens.)
NNRTI-Based Regimens
(alphabetical order)
Î EFV
a
+ ZDV
e
/3TC
b
(CI)
Î NVP
i
+ (TDF/FTC
b
or
ZDV
e
/3TC
b
) (CI)
PI-Based Regimens
(alphabetical order)
Î ATV
c, j
+ (ABC
d
or ZDV
e
)/3TC
b
(CI)
Î ATV/r
c
+ ZDV
e
/3TC
b
(CI)
Î FPV/r + ZDV
e
/3TC
b
(CI)
Î LPV/r
h
+ ZDV
e
/3TC
b
(CI)
CCR5 Antagonist-Based Regimen
Î MVC
k
+ ZDV
e
/3TC
b
(CI)
INSTI-Based Regimen
Î RAL + ABC
d
/3TC
b
(BIII)
