Next generation fixed dose combination pharmacotherapies for treating HIV.

INTRODUCTION: Treatment options for patients with HIV-1 infection have grown over the past two decades to include multiple fixed-dose combination pharmacotherapies that have greatly simplified administration of antiretroviral therapy (ART) for both patients and providers. Effective virologic control can often be achieved with once-daily use of a single-tablet regimen. Over the past three years, ART drug development has focused on the next generation of fixed-dose combinations for initial and maintenance therapy with improved efficacy, safety and tolerability. AREAS COVERED: This review covers pre-clinical and clinical data searched through PubMed and presented at major conferences through November 2017. EXPERT OPINION: Currently available single-tablet regimens have clinical limitations related to adverse event profiles, drug-drug and drug-food interactions and variable barriers to resistance. Anticipated advances in ART fixed-dose combinations promise combinations of current multiple tablet regimens into single tablets, as well as combinations with novel drugs with improved safety and tolerability. The traditional dogma of effective ART containing at least three active antiretroviral drugs is being challenged by promising data to support efficacy of certain regimens containing two drugs. Implementation of next generation ART will bring to light issues of clinical preference and cost-effectiveness as patents of existing drugs expire and more generic formulations become available.