Application of bictegravir/emtricitabine/tenofovir alafenamide in rapid initiation of antiretroviral therapy: a review

Rapid initiation of antiretroviral therapy (rapid ART) has multiple clinical benefits, such as increasing the rates of treatment initiation, retention in care, and virologic suppression, and reducing the mortality rate. It is crucial for the achievement of the “95%–95%–95%” goal in China and the globe. Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is a single-tablet combination based on the second-generation integrase inhibitor bictegravir. B/F/TAF has a high resistance barrier and a favourable safety profile, and can be initiated before baseline laboratory results are available. It is not only a first-line ART regimen recommended by the latest established guidelines but also the only single-tablet regimen unanimously recommended by local and international guidelines for rapid ART. A number of prospective clinical trials and cohort studies on the use of B/F/TAF for rapid ART are currently ongoing in China and across the world, including studies using same-day initiation. This article summarizes the existing clinical evidence and briefly discusses the considerations for the use of B/F/TAF for rapid ART in some special populations, aiming to inform the clinical practice of medical personnel engaged in the diagnosis and treatment of HIV infection.