Current WHO and DHHS 2024 guidelines recommend initiating antiretroviral therapy (ART) in all newly diagnosed HIV-positive individuals regardless of CD4 count. Which two-drug regimen is now approved as a complete regimen for HIV treatment (not just maintenance) in virologically suppressed patients?

• A Tenofovir + emtricitabine (2-drug NRTI backbone)
• B Efavirenz + rilpivirine (dual NNRTI therapy)
• C Cabotegravir + rilpivirine (injectable monthly regimen only)
• D Dolutegravir + lamivudine (GEMINI trial evidence) ✓

Explanation

Dolutegravir + lamivudine (DTG/3TC, as Dovato) is the first approved 2-drug complete regimen for treatment-naive HIV patients without resistance concerns, supported by the GEMINI 1 and GEMINI 2 trials demonstrating non-inferiority to standard 3-drug tenofovir alafenamide/emtricitabine/dolutegravir at 96 weeks. It reduces long-term toxicity from tenofovir and improves tolerability. Cabotegravir + rilpivirine (ATLAS and FLAIR trials) is the monthly injectable long-acting ART for virologically suppressed patients. DTG/3TC is now in WHO preferred regimens for initial ART in treatment-naive patients without hepatitis B co-infection.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.