• Doravirina esquema recomendado en las nuevas guías EACS 2021 de tratamiento Antirretroviral del HIV.
Regímenes recomendados
| Regimen | Main requirements | Additional Guidance (see footnotes) |
| Recommended regimens | ||
| 2 NRTIs = INSTI | ||
| ABC/3TC = DTG ABC/3TC/DTG | HLA-B*57:01 negative HBsAg negative | I (ABC: HLA-B*57:01, cardiovascular risk) II (Weight increase (DTG)) |
| TAF/FTC/BIC | II (Weight increase (BIC, TAF)) | |
| TAF/FTC OR TDF/XTC + DTG | II (Weight increase (DTG, TAF)) III (TDF: prodrug types. Renal and bone toxicity. TAF dosing) | |
| TAF/FTC OR TDF/XTC = RAL qd or bid | II (Weight increase (RAL, TAF)) III (TDF: prodrug types. Renal and bone toxicity. TAF dosing) IV (RAL: dosing) |
| 1 NRTI = INSTI | ||
| XTC + DTG or 3TC/DTG | HBsAg negative HIV-VL < 500,000 copies/mL Not recommended after PrEP failure | II (Weight increase (DTG)) V (3TC/DTG not after PrEP failure) |
| 2 NRTIs = INSTI | ||
| TAF/FTC OR TDF/XTC + DOR or TDF/3TC/DOR | II (Weight increase (TAF)) III (TDF: prodrug types. Renal and bone toxicity. TAF dosing) IV (DOR: caveats, HIV-2) |
| Alternative regimens | ||
| 2 NRTIs = INSTI | ||
| ABC/3TC + RAL 400 mg bid | HBsAg negative HLA-B*57:01 negative | I (ABC: HLA-B*57:01, may delay starting ART) V (RAL in pregnancy, bid dosing) |
| 2 NRTIs = NNRTI | ||
| ABC/3TC + EFV | HLA-B*57:01 negative HBsAg negative HIV-VL < 100,000 copies/mL At bedtime or 2 hours before dinner | I (ABC: HLA-B*57:01, may delay starting ART) VIII (EFV HIV-2 & group 0) |
| TDF/XTC of TAF/FTC = EFV or TDF/FTC/EFV | At bedtime or 2 hours before dinner TAF/FTC not recommended in first 14 weeks of pregnancy | III (Tenofovir salts) IV (TAF & pregnancy) VIII (EFV HIV-2 & group 0) |
| TDF/XTC of TAF/FTC = RPV or TDF/FTC/RPV or TAF/FTC/RPV | CD4 count > 200 cells/μL HIV-VL < 100,000 copies/mL Not on gastric pH increasing agents With food TAF/FTC not recommended in first 14 weeks of pregnancy | II (Tenofovir salts) IV (TAF & pregnancy) IX (RPV exposure during 2nd and 3rd trimester, HIV-2) X (Interactions) |
| 2 NRTIs = PI/r | ||
| ABC/3TC + DRV/r 600 mg/100 mg bid | HLA-B*57:01 negative HBsAg negative With food | I (ABC: HLA-B*57:01, may delay starting ART) VI (DRV dosing) VII (COBI boosting) |
• El objetivo de la modificación del tratamiento debe ser eliminar o mejorar los eventos adversos, facilitar el tratamiento adecuado de las comorbilidades y mejorar la calidad de vida, el tratamiento con INSTI o TAF podría estar asociado a incremento de peso.
• Si el regimen antirretroviral no incluye un booster, TAF o TDF tienen un riesgo similar de eventos renales que llevan a la discontinuación a corto plazo y de fracturas ósea.
Lo invitamos a conocer las guías EACS.
