24
Selecting a Treatment Regimen
Table 7. Antiretroviral Regimen Considerations as Initial
Therapy based on Specific Clinical Scenarios
Patient or
Regimen
Characteristics Clinical Scenario Consideration(s)
Pre-ART
Characteristics
CD4 count
<200 cells/mm
3
Do NOT use the following regimens:
• RPV-based regimens
• DRV/r plus RAL
HIV RNA
>100,000 copies/mL
Do NOT use the following regimens:
• RPV-based regimens
• ABC/3TC with EFV or ATV/r
• DRV/r plus RAL
HLA-B*5701
positive
Do NOT use ABC-containing regimens.
ARV must be
started before
HIV drug resistance
results are available
(e.g., in a person
with acute HIV or
when a rapid
initiation of ART
is warranted).
Avoid NNRTI-based regimens.
Recommended ART Regimens:
• DRV/r or DRV/r + tenofovir
a
/FTC; or
• DTG + tenofovir
a
/FTC
ART-Specific
Characteristics
A one-pill, once-
daily regimen is
desired.
Single-tablet regimen (STR) options
include:
• DTG/ABC/3TC
• EFV/TDF/FTC
• EVG/c/TAF/FTC
• EVG/c/TDF/FTC
• RPV/TAF/FTC
• RPV/TDF/FTC
Food effects Regimens that can be taken without
regard to food:
• RAL- or DTG-based regimens
Regimens that should be taken with food:
• ATV/r- or ATV/c-based regimens
• DRV/r- or DRV/c-based regimens
• EVG/c/TDF/FTC
a
• EVG/c/TAF/FTC
a
• RPV-based regimens
Regimens that should be taken on an
empty stomach:
• EFV-based regimens