ArticleBMC infectious diseases2026
Efficacy and safety of bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) versus efavirenz, lamivudine, and tenofovir disoproxil fumarate (EFV+3TC + TDF) in late-presenting people with HIV rapid initial antiretroviral therapy.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare the efficacy and safety of BIC/FTC/TAF versus EFV+3TC + TDF for rapid ART initiation in late-presenting (CD4 < 200 cells/µL) people with HIV in the real world.
methodsThis retrospective cohort included 366 ART-naïve adults at Beijing Ditan Hospital (2021–2024). Patients were stratified by opportunistic infection (OI) status and initiated on either BIC/FTC/TAF or EFV+3TC + TDF. The primary endpoint was virological suppression (HIV-1 RNA < 50 copies/mL) at Week 48.
resultsAt Week 48, virological suppression rates were significantly higher with BIC/FTC/TAF versus EFV+3TC + TDF in both patients without OIs (92.4% vs. 62.5%) and with OIs (92.3% vs. 55.9%). Treatment retention was also superior with BIC/FTC/TAF (94.1% vs. 62.3%). Kaplan-Meier analysis confirmed a higher cumulative probability of maintaining suppression with BIC/FTC/TAF (96.7% vs. 80.4%, log-rank p < 0.001). Pre-treatment drug resistance in NNRTIs was present in 11.6% of the EFV group and 1.4% of the BIC group. Acquired resistance emerged only in the EFV group (10.8% by Week 24). CD4 + T-cell counts in both groups increased. BIC/FTC/TAF was associated with early, stable increases in creatinine and lipids, while EFV+3TC + TDF showed a marked triglyceride rise.
conclusionIn this real-world cohort of late-presenting people with HIV, BIC/FTC/TAF demonstrated superior virological efficacy, treatment retention, and resistance profile over EFV+3TC + TDF, supporting its use in rapid ART initiation.
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