Bictegravir/emtricitabine/tenofovir alafenamide for HIV: a meta-analysis of efficacy across treatment-naïve and experienced populations and comparative effectiveness versus dolutegravir/lamivudine
Abstract
ObjectivesBictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) is a preferred single-tablet regimen for HIV treatment, but head-to-head meta-analytic comparisons between treatment-experienced (TE) and treatment-naïve (TN) individuals are lacking. Additionally, the comparative effectiveness of BIC/FTC/TAF versus dolutegravir/lamivudine (DTG/3TC) remains to be systematically synthesized. We aimed to systematically compare the efficacy of BIC/FTC/TAF between TE and TN people with HIV, and evaluate the comparative effectiveness of BIC/FTC/TAF versus DTG/3TC.MethodsWe searched PubMed, Cochrane Library, Web of Science, and Embase up to September 2026. Observational studies and randomized controlled trials (RCTs) reporting virologic suppression or treatment discontinuation rates in both TE and TN populations receiving BIC/FTC/TAF, or BIC/FTC/TAF versus DTG/3TC were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Single-group proportion meta-analyses used a random-effects model, whereas comparative meta-analyses used the prespecified fixed-effect model.ResultsThirty-one studies were included. For TE participants, the pooled virologic suppression rate was 95% (95% CI: 92%–97%) at 12 months, and for TN participants, the rate was 90% (95% CI: 85%–94%). In design-stratified comparative analyses between BIC/FTC/TAF and DTG/3TC, no statistically significant difference was detected in RCT (OR = 1.46, 95% CI: 0.80–2.66) or cohort studies (OR = 0.98, 95% CI: 0.70–1.39) among TN populations, nor in TE populations (RCT: OR = 1.04, 95% CI: 0.34–3.16; cohort: OR = 0.92, 95% CI: 0.42–2.02). No statistically significant differences were detected for treatment discontinuation (all-cause: OR = 1.02, 95% CI: 0.70–1.49; adverse events: OR = 1.11, 95% CI: 0.55–2.22).ConclusionBIC/FTC/TAF achieves high virologic suppression rates and low discontinuation rates in both TE and TN populations, supporting its use as a first-line and switch option. BIC/FTC/TAF and DTG/3TC showed no statistically significant differences in virologic suppression or treatment discontinuation, suggesting both are viable guideline-preferred options. The choice between them should be individualized based on patient characteristics, including prior treatment history, adherence potential, comorbidity profile, and metabolic risk considerations.
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BibTeX
@article{cheng2026bictegraviremtricitabinetenofovir,
title = {{Bictegravir/emtricitabine/tenofovir alafenamide for HIV: a meta-analysis of efficacy across treatment-naïve and experienced populations and comparative effectiveness versus dolutegravir/lamivudine}},
author = {Mingxia Cheng and Aiwen Wang and Qingshuang Zhu and Hua Duan and Kangle Guo and Li Li and Shixun Ma and Jin He and Kehu Yang},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1935865},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1935865},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Bictegravir/emtricitabine/tenofovir alafenamide for HIV: a meta-analysis of efficacy across treatment-naïve and experienced populations and comparative effectiveness versus dolutegravir/lamivudine
AU - Mingxia Cheng
AU - Aiwen Wang
AU - Qingshuang Zhu
AU - Hua Duan
AU - Kangle Guo
AU - Li Li
AU - Shixun Ma
AU - Jin He
AU - Kehu Yang
PY - 2026
DA - 2026/10/30
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1935865
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1935865
AB - ObjectivesBictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) is a preferred single-tablet regimen for HIV treatment, but head-to-head meta-analytic comparisons between treatment-experienced (TE) and treatment-naïve (TN) individuals are lacking. Additionally, the comparative effectiveness of BIC/FTC/TAF versus dolutegravir/lamivudine (DTG/3TC) remains to be systematically synthesized. We aimed to systematically compare the efficacy of BIC/FTC/TAF between TE and TN people with HIV, and evaluate the comparative effectiveness of BIC/FTC/TAF versus DTG/3TC.MethodsWe searched PubMed, Cochrane Library, Web of Science, and Embase up to September 2026. Observational studies and randomized controlled trials (RCTs) reporting virologic suppression or treatment discontinuation rates in both TE and TN populations receiving BIC/FTC/TAF, or BIC/FTC/TAF versus DTG/3TC were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Single-group proportion meta-analyses used a random-effects model, whereas comparative meta-analyses used the prespecified fixed-effect model.ResultsThirty-one studies were included. For TE participants, the pooled virologic suppression rate was 95% (95% CI: 92%–97%) at 12 months, and for TN participants, the rate was 90% (95% CI: 85%–94%). In design-stratified comparative analyses between BIC/FTC/TAF and DTG/3TC, no statistically significant difference was detected in RCT (OR = 1.46, 95% CI: 0.80–2.66) or cohort studies (OR = 0.98, 95% CI: 0.70–1.39) among TN populations, nor in TE populations (RCT: OR = 1.04, 95% CI: 0.34–3.16; cohort: OR = 0.92, 95% CI: 0.42–2.02). No statistically significant differences were detected for treatment discontinuation (all-cause: OR = 1.02, 95% CI: 0.70–1.49; adverse events: OR = 1.11, 95% CI: 0.55–2.22).ConclusionBIC/FTC/TAF achieves high virologic suppression rates and low discontinuation rates in both TE and TN populations, supporting its use as a first-line and switch option. BIC/FTC/TAF and DTG/3TC showed no statistically significant differences in virologic suppression or treatment discontinuation, suggesting both are viable guideline-preferred options. The choice between them should be individualized based on patient characteristics, including prior treatment history, adherence potential, comorbidity profile, and metabolic risk considerations.
SN - 1663-9812
ER -