As most of you are aware, the treatment of HIV requires multiple drugs. Since the mid-nineties, the rule has been to use three drugs to control HIV, but sometimes that wasn’t possible if the patient was resistant to drugs or had serious side-effects of drug-interactions.
In late 2017, the US approved the first two-drug combination, Juluca (dolutegravir + rilpivirine). Then, earlier this year, Dovato was approved (Dolutegravir + lamivudine). So we are seeing a continuing theme where less is more, as I have written about previously.
It was the use of triple-drug combinations with potent drugs in the mid to late 1990s that led us to control HIV infection in patients. Triple drug combinations suppressed the virus to undetectable levels but also made it more difficult for the virus to become resistant to the drugs.
On the downside, taking three drugs meant more pills to take and higher costs, at least until we combined them into
