Combination Therapies

Reviewed by: HU Medical Review Board | May 2024 | Last updated: May 2024

Treatment with multiple HIV medicines from a variety of different drug classes has been shown to be the most effective in helping people with HIV achieve viral suppression. Using multiple medicines or types of medicines to treat HIV is referred to as antiretroviral therapy (ART) or combination antiretroviral therapy (cART).1-3

In the past, HIV treatment options were available only as monotherapies, or drugs that contained one active ingredient. Today, combination therapies that combine multiple medications, sometimes from different drug classes, are available in medicine. This helps make taking and sticking to HIV treatment simpler, which is especially important in preventing HIV from mutating and developing resistance against a drug.1-3

How do combination therapies work?

Each medicine that is part of a combination therapy works to stop HIV at a different part of the virus' replication process. Combination therapy cannot cure HIV, but it can reduce the levels in HIV in your body.1-3

Examples of combination therapies for HIV

Several combination therapies are designed to be stand-alone treatments and should not be taken with other HIV drugs. Others need to be taken with additional HIV therapies. Talk to your doctor about which combination therapy may be right for you.1-3

NRTI combination therapies

NRTI combination therapies use 2 or more nucleoside reverse transcriptase inhibitor (NRTI) drugs. Examples of NRTI combination therapies include:1-3

  • Cimduo® (lamivudine and tenofovir disoproxil fumarate)
  • Combivir (lamivudine and zidovudine)
  • Descovy® (emtricitabine and tenofovir alafenamide)
  • Epzicom (abacavir and lamivudine)
  • Trizivir (abacavir, lamivudine, and zidovudine)
  • Truvada® (emtricitabine and tenofovir disoproxil fumarate)

NRTI/NNRTI combination therapies

NRTI/NNRTI combination therapies typically use 2 NRTI drugs and 1 non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. Examples of NRTI/NNRTI combination therapies include:1-3

  • Atripla™ (efavirenz, emtricitabine, and tenofovir disoproxil fumarate)
  • Complera (emtricitabine, rilpivirine, and tenofovir disoproxil fumarate)
  • Delstrigo® (doravirine, lamivudine, and tenofovir disoproxil fumarate)
  • Odefsey® (emtricitabine, rilpivirine, and tenofovir alafenamide)
  • Symfi®/Symfi Lo® (efavirenz, lamivudine, and tenofovir disoproxil fumarate)

NRTI/integrase inhibitor combination therapies

NRTI combination therapies use 1 or more NRTI drugs and 1 integrase inhibitor drug. Examples of NRTI/integrase inhibitor combination therapies include:1-3

  • Biktarvy® (bictegravir, emtricitabine, and tenofovir alafenamide)
  • Dovato (dolutegravir and lamivudine)
  • Triumeq (abacavir, dolutegravir, and lamivudine)

NNRTI/integrase inhibitor combination therapies

NNRTI combination therapies typically use 1 NNRTI drug and 1 integrase inhibitor drug. Examples of NNRTI/integrase inhibitor combination therapies include:1-3

  • Cabenuva (cabotegravir and rilpivirine)
  • Juluca (dolutegravir and rilpivirine)

Protease inhibitor therapies

Protease inhibitor combination therapies typically use 2 protease inhibitor drugs. Examples of protease inhibitor combination therapies include:1-3

Protease inhibitor/pharmacokinetic enhancer combination therapies

Protease inhibitor/pharmacokinetic enhancer combination therapies typically use 1 protease inhibitor drug and 1 pharmacokinetic enhancer drug. Examples of protease inhibitor/pharmacokinetic enhancer combination therapies include:1-3

Multi-class combination therapies for HIV

Other combination therapies are available that combine 3 different drug classes. Examples include:1-3

  • Genvoya®, an NRTI/integrase inhibitor/pharmacokinetic enhancer (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide)
  • Stribild™, an NRTI/integrase inhibitor/pharmacokinetic enhancer (elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate)
  • Symtuza®, an NRTI/protease inhibitor/pharmacokinetic enhancer combination (darunavir, cobicistat, emtricitabine, and tenofovir alafenamide)

Before beginning treatment for HIV, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

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Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.