What is the recommended combination for initiating antiretroviral therapy?

The recommended combination for initiating antiretroviral therapy involves the use of a protease inhibitor (PI), a pharmacokinetic enhancer, and an integrase strand transfer inhibitor (INSTI) because this combination provides a robust and effective approach to managing HIV.

Using a PI in conjunction with a pharmacokinetic enhancer helps to increase the effectiveness of the pharmacotherapy by improving the absorption and lowering the metabolism of the PI, thus allowing for more consistent drug levels in the body. The addition of an INSTI complements this regimen by directly targeting the integration of viral DNA into the host genome, reducing the ability of the virus to replicate and establish infection.

This combination not only improves the chances of viral suppression but also mitigates the risk of developing resistance against the treatment. By using agents from different classes, the likelihood of achieving durable viral suppression while minimizing potential side effects is significantly enhanced.

In contrast, the other combinations lack the same efficacy or could lead to suboptimal results, whether due to limited viral suppression or potential resistance development.