HIV/AIDS Research Suggests Switching to Two-Drug Regimen May Reduce Clinical Risk in Virologically Suppressed Patients

Strategic Insights -

Researchers from Azienda Ospedale University Policlinico in Modena, Italy, have found that switching to a two-drug regimen (2DR) may reduce the clinical risk in virologically suppressed patients with HIV (PWH) compared to remaining on a three-drug regimen (3DR). The study, which included a large cohort of PWH in Italy, found that over a 3-year follow-up period, 408 clinical events were registered, including cardiovascular disease, cancer, and death. The results suggest that switching to 2DR may slightly reduce the risk of a composite clinical outcome in PWH.

Key Takeaways:

  • The study involved 7672 participants, with 629 (8.2%) switching to 2DR and 7043 (91.8%) remaining on 3DR.
  • Over the 3-year follow-up period, 408 events were registered, including 64 CVD, 234 cancer, and 110 deaths.
  • The 3-year adjusted risk estimate was 2.55 (95% CI 1.72, 5.33) in 2DR vs. 4.69 (95% CI 4.48, 6.17) in 3DR.
  • The difference in 3-year risk between therapeutic strategies was -2.15% (95% CI -3.56%, -0.20%) in favor of 2DR.
  • The study found that the difference in risk was mainly driven by events of non-AIDS related cancer and mortality.
  • The study provides evidence that virologically suppressed PWH can be safely switched to 2DR.

Statistics:

  • 7672 participants entered the analysis.
  • 629 (8.2%) out of 7672 participants switched to 2DR.
  • 4048 (91.8%) out of 7672 participants remained on 3DR.
  • 408 clinical events were registered over the 3-year follow-up period.
  • 64 CVD, 234 cancer, and 110 deaths were among the registered events.
  • The 3-year adjusted risk estimate was 2.55 (95% CI 1.72, 5.33) in 2DR vs. 4.69 (95% CI 4.48, 6.17) in 3DR.
  • The difference in 3-year risk between therapeutic strategies was -2.15% (95% CI -3.56%, -0.20%) in favor of 2DR.

Sources:

  • NewsRx. Findings on HIV/AIDS Reported by Investigators at Azienda Ospedale University Policlinico (Risk of Clinical Events In Virologically Suppressed People With Hiv Switching To a Two-drug Regimen Vs. Remaining On a Three-drug Regimen: a Target Trial ...). AIDS Weekly. October 20, 2025; p 81.