Triumeq vs. Biktarvy for HIV Treatment: Important Differences and Potential Risks.

Key takeaways

Triumeq (abacavir/dolutegravir/lamivudine) and Biktarvy (bictegravir/emtricitabine/tenofovir) are both single-tablet regimens used to treat HIV, but they have some key differences. Triumeq requires a genetic test before starting treatment to check for a specific trait that could cause a serious allergic reaction, while Biktarvy does not. Triumeq is available in two forms: a tablet for adults and children over 55 lbs, and a dissolvable tablet for children between 13 lbs and 54 lbs. Biktarvy, on the other hand, is only available as a tablet for those weighing at least 30 lbs. Both medications can cause liver problems and need to be taken with caution if you have severe liver or kidney issues. Both medications are also brand-only and can be expensive.

Triumeq

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Biktarvy

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Summary for Triumeq

Prescription only

Triumeq is a single-tablet regimen used to treat human immunodeficiency virus (HIV) infections. It contains 3 antiretrovirals (ARVs): abacavir, dolutegravir, and lamivudine. Triumeq is available as either a tablet or a dissolvable tablet for oral suspension (Triumeq PD), but the two are not the same. Before starting treatment, your provider will require you to get a genetic test to see if you're at risk for developing a serious allergic reaction to this medication.

Indications for Triumeq

Treatment of HIV infection (in people who weigh at least 13 pounds)

Pros and Cons for Triumeq

Pros

Only taken once a day for complete HIV treatment
Combines three medications into one pill for convenience
Can be taken with or without food
Available for adults and children at or over 22 lbs

Cons

Dose can't be adjusted so it's not recommended for people with kidney or liver problems
Not safe to use in severe liver problems
Requires a genetic test before starting
Interacts with a lot of medications such as St. John’s wort and oxcarbazepine (Trileptal)

Common Side Effects for Triumeq

Higher lipase levels (suggesting irritated pancreas) (up to 11%)
Higher blood sugar levels (up to 9%)
Higher creatine kinase levels in the blood (suggesting muscle damage) (up to 7%)
Higher fat levels in the blood (up to 6%)
Higher white blood cell count (up to 4%)
Abnormal liver labs (up to 3%)
Trouble sleeping (3%)
Headache (2%)
Feeling tired (2%)

Please note: The side effects listed above are from clinical trials with Tivicay (dolutegravir) and Epzicom (abacavir / lamivudine), which are all active ingredients in Triumeq and Triumeq PD

Warnings for Triumeq

Serious allergic reaction
Worsening of hepatitis B virus (HBV) infection
Liver problems
Overactive immune system
Interaction with other medications

Summary for Biktarvy

Prescription only

Biktarvy is a combination antiretroviral that contains bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF). It's a complete antiretroviral therapy (ART) to treat human immunodeficiency virus (HIV) infections in adults and children who weigh at least 30 pounds. Biktarvy isn't used for HIV pre-exposure prophylaxis (PrEP), but it is a first-choice option for people starting HIV treatment. Typically, this medication is taken by mouth once daily. Biktarvy doesn't commonly cause weight gain, but it can cause other side effects, such as nausea, diarrhea, and headache.

Indications for Biktarvy

Treatment of HIV infection in adults and children weighing at least 30 lbs, and:

Starting HIV treatment for the first time, or
HIV viral load hasn't been fully controlled with previous ART, and don't have resistance to certain medications
Have a HIV viral load of less than 50 copies/mL from a previous ART

Pros and Cons for Biktarvy

Pros

Only taken once a day
First-choice option for people who've never taken ART
Possible option during pregnancy

Cons

Might not be safe for people with kidney or liver problems
Must take at least 2 hours before or 6 hours after antacids containing magnesium or aluminum
Must store in original bottle