Recommendation on Integrase Inhibitor Use in Antiretroviral Treatment-Naive HIV-Infected Individuals from the HHS Panel on Antiretroviral Guidelines for Adults and Adolescents


In the February 12, 2013, version of the Health and Human Services (HHS) Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents, the Panel recommendations on initial combination regimens for the antiretroviral therapy (ART)-naive, HIV-infected patient include raltegravir (RAL) plus tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) as the preferred integrase strand transfer inhibitor (INSTI)-based regimen, and elvitegravir (EVG)/cobicistat (cobi)/TDF/FTC as an alternative regimen for patients with estimated creatinine clearance (CrCl) ≥70 mL/min. Since the release of the Guidelines, a new INSTI, dolutegravir (DTG), was approved for use in ART-naive and ART-experienced patients. Additionally, long-term follow-up data (up to 144 weeks) from randomized clinical trials have demonstrated the durable safety and efficacy of EVG/cobi/TDF/FTC.
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