The use of a combination antiretroviral therapy (cART) has changed dramatically the prognosis and the life expectancy of people living with HIV. The current treatment guidelines continue the convention of preferred cART based on combining a dual nucleoside reverse-transcriptase inhibitor (NRTI) backbone with a third "anchor" agent, such as a ritonavir (r)- or cobicistat (c)-boosted protease inhibitor (PI), a non-NRTI (NNRTI), or an integrase inhibitor (INI) boosted or unboosted. However, due to toxicities of NRTIs, sparing NRTI regimen has been studied for a long time with moderate success due to low efficacy (especially in patients with high viral load and low CD4) compare to standard triple therapy. New strategy with lamivudine (3TC) plus a boosted PI or INI showed promise results and indicated that modern two-drug regimens might now, in fact, become a reliable treatment for HIV-infected naïve patients. This article discusses recent data from dual therapy studies in naïve HIV-infected patients and the challenges behind this strategy.

中文翻译：

---

抗逆转录病毒两药疗法是天真的患者接受HIV治疗的新标准吗？

联合使用抗逆转录病毒疗法（cART）已大大改变了HIV感染者的预后和预期寿命。当前的治疗指南基于将双重核苷逆转录酶抑制剂（NRTI）骨架与第三种“锚定”药物（如利托那韦（r）或考比司他（c）增强蛋白酶抑制剂）结合使用，继续遵循首选cART的惯例。 PI），非NRTI（NNRTI）或整合酶抑制剂（INI）增强或增强。然而，由于NRTIs的毒性，与标准的三联疗法相比，由于低效（特别是在高病毒载量和低CD4的患者中），由于NRTI的毒性，长期以来人们一直在研究节省NRTI方案，并取得了一定的成功。拉米夫定（3TC）加上增强的PI或INI的新策略显示出可喜的结果，并表明现代两药疗法现在可能会出现，实际上，它已成为感染HIV的初次患者的可靠治疗方法。本文讨论了针对单纯HIV感染患者的双重疗法研究的最新数据以及该策略背后的挑战。