A 29-year-old cisgender woman recently diagnosed with HIV presents to clinic for follow-up. Her baseline laboratory studies showed a CD4 count of 257 cells/mm3 and an HIV RNA level of 42,690 copies/mL. She initially took bictegravir-tenofovir alafenamide-emtricitabine for about 10 days but did not tolerate it due to sleep problems and is not willing to take any other similar regimen. She is asking to receive a single tablet regimen. She is HLA-B*5701 positive. You discuss possible single-tablet regimen options and are planning to use a regimen with a non-nucleoside reverse transcriptase inhibitor (NNRTI) for the anchor drug.
Which one of the following is TRUE about the following single-tablet non-nucleoside reverse transcriptase inhibitor (NNRTI)-based options?

Figure 1. Pooled Data From ECHO and THRIVE Studies: Virologic Response by Baseline HIV RNA Level.
Patients were randomized to receive either efavirenz-tenofovir DF-emtricitabine or rilpivirine-tenofovir DF-emtricitabine. This graph shows proportion of patients with HIV RNA less than 50 copies/mL stratified by baseline HIV RNA levels.
Source: Cohen CJ, Molina JM, Cahn P, et al. Efficacy and safety of rilpivirine (TMC278) versus efavirenz at 48 weeks in treatment-naive HIV-1-infected patients: pooled results from the phase 3 double-blind randomized ECHO and THRIVE Trials. J Acquir Immune Defic Syndr. 2012;60:33-42.

Figure 2. 48-Week Virologic Data in the DRIVE AHEAD Studt
This graph shows similar levels of HIV RNA suppression in treatment-naïve individuals receiving doravirine-tenofovir DF-emtricitabine or efavirenz-tenofovir DF-emtricitabine. The similar response were also seen in those with baseline HIV RNA levels greater than 100,000 copies/mL.
Source: Orkin C, Squires KE, Molina JM, et al. Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate is Non-inferior to Efavirenz/Emtricitabine/Tenofovir Disoproxil Fumarate in Treatment-naive Adults With Human Immunodeficiency Virus-1 Infection: Week 48 Results of the DRIVE-AHEAD Trial. Clin Infect Dis. 2019;68:535-44.
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Question Last Updated
September 21st, 2023
September 21st, 2023
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