Regimens and BHIVA tiers
The regimens the engine considers, how each is taken in the UK, and its tier in each clinical scenario under the BHIVA adult ART guidelines (2025 interim update, Tables 5.1 and 5.2) and the BHIVA pregnancy guidelines (2025, Table 8.3). Each tier links to the section it comes from. “—” means it is not offered in that scenario. Section 7 of the adult guideline gives principles rather than a table for virological failure, so those tiers apply them (high-barrier anchors first).
| Regimen | Products | Dosing | First-line | Starting in pregnancy | Suppressed switch | Virological failure |
|---|---|---|---|---|---|---|
| BIC/FTC/TAF INSTI |
Biktarvy 50/200/25 mg — one tablet once daily With or without food |
Recommended for most people BHIVA ART 2025 §5 |
Limited pregnancy data BHIVA pregnancy 2025 §8.1 |
Recommended (first-line option) BHIVA ART 2025 §5 |
Alternative BHIVA ART 2025 §7.5 |
|
| DTG/3TC INSTI 2-drug |
Dovato 50/300 mg — one tablet once daily With or without food |
Recommended for most people BHIVA ART 2025 §5 |
Limited pregnancy data BHIVA pregnancy 2025 §8.1 |
Recommended (first-line option) BHIVA ART 2025 §5 |
— | |
| DTG + FTC/TAF INSTI |
Tivicay 50 mg once daily + Descovy 200/25 mg once daily With or without food |
Recommended for most people BHIVA ART 2025 §5 |
Recommended in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Recommended (first-line option) BHIVA ART 2025 §5 |
Preferred (high barrier) BHIVA ART 2025 §7.5 |
|
| DTG + FTC/TDF INSTI |
Tivicay 50 mg once daily + emtricitabine/tenofovir disoproxil 200/245 mg once daily FTC/TDF preferably with food |
Recommended for most people BHIVA ART 2025 §5 |
Recommended in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Recommended (first-line option) BHIVA ART 2025 §5 |
Preferred (high barrier) BHIVA ART 2025 §7.5 |
|
| DTG/ABC/3TC INSTI |
Triumeq 50/600/300 mg — one tablet once daily With or without food |
Certain clinical situations BHIVA ART 2025 §5 |
Recommended in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Alternative BHIVA ART 2025 §7.5 |
|
| DRV/c/FTC/TAF PI |
Symtuza 800/150/200/10 mg — one tablet once daily with food With food |
Certain clinical situations BHIVA ART 2025 §5 |
Limited pregnancy data BHIVA pregnancy 2025 §8.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Preferred (high barrier) BHIVA ART 2025 §7.5 |
|
| DRV/c + FTC/TDF PI |
Rezolsta 800/150 mg once daily with food + emtricitabine/tenofovir disoproxil once daily With food |
Certain clinical situations BHIVA ART 2025 §5 |
Limited pregnancy data BHIVA pregnancy 2025 §8.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Preferred (high barrier) BHIVA ART 2025 §7.5 |
|
| DRV/r + FTC/TAF PI |
Prezista 800 mg + Norvir 100 mg once daily with food + Descovy 200/10 mg once daily With food |
Certain clinical situations BHIVA ART 2025 §5 |
Alternative in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Preferred (high barrier) BHIVA ART 2025 §7.5 |
|
| DRV/r + FTC/TDF PI |
Prezista 800 mg + Norvir 100 mg once daily with food + emtricitabine/tenofovir disoproxil once daily With food |
Certain clinical situations BHIVA ART 2025 §5 |
Alternative in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Preferred (high barrier) BHIVA ART 2025 §7.5 |
|
| ATV/r + FTC/TDF PI |
Atazanavir 300 mg + Norvir 100 mg once daily with food + emtricitabine/tenofovir disoproxil once daily With food |
— | — | Acceptable for switch BHIVA ART 2025 §5.10 |
Alternative BHIVA ART 2025 §7.5 |
|
| RAL + FTC/TAF INSTI |
Isentress 1,200 mg (2 × 600 mg) once daily + Descovy 200/25 mg once daily With or without food |
Certain clinical situations BHIVA ART 2025 §5 |
Alternative in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Other BHIVA ART 2025 §7.5 |
|
| RAL + FTC/TDF INSTI |
Isentress 1,200 mg (2 × 600 mg) once daily + emtricitabine/tenofovir disoproxil once daily With or without food |
Certain clinical situations BHIVA ART 2025 §5 |
Alternative in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Other BHIVA ART 2025 §7.5 |
|
| DOR/3TC/TDF NNRTI |
Delstrigo 100/300/245 mg — one tablet once daily With or without food |
Certain clinical situations BHIVA ART 2025 §5 |
Limited pregnancy data BHIVA pregnancy 2025 §8.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Other BHIVA ART 2025 §7.5 |
|
| DOR + FTC/TAF NNRTI |
Pifeltro 100 mg once daily + Descovy 200/25 mg once daily With or without food |
Certain clinical situations BHIVA ART 2025 §5 |
Limited pregnancy data BHIVA pregnancy 2025 §8.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Other BHIVA ART 2025 §7.5 |
|
| RPV/FTC/TAF NNRTI |
Odefsey 200/25/25 mg — one tablet once daily with food With a meal |
— | Alternative in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Other BHIVA ART 2025 §7.5 |
|
| RPV/FTC/TDF NNRTI |
Eviplera 200/25/245 mg — one tablet once daily with food With a meal |
— | Alternative in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Acceptable for switch BHIVA ART 2025 §5.10 |
Other BHIVA ART 2025 §7.5 |
|
| EFV/FTC/TDF NNRTI |
Efavirenz/emtricitabine/tenofovir disoproxil 600/200/245 mg — one tablet once daily on an empty stomach, preferably at bedtime Empty stomach, at bedtime |
— | — | Maintenance only BHIVA ART 2025 §5.10 |
— | |
| EFV + FTC/TDF NNRTI |
Efavirenz 600 mg at bedtime on an empty stomach + emtricitabine/tenofovir disoproxil once daily Efavirenz on an empty stomach, at bedtime |
Certain clinical situations BHIVA ART 2025 §5 |
Alternative in pregnancy BHIVA pregnancy 2025 §8.3.1 |
Maintenance only BHIVA ART 2025 §5.10 |
Other BHIVA ART 2025 §7.5 |
|
| DTG/RPV INSTI NNRTI 2-drug |
Juluca 50/25 mg — one tablet once daily with a meal With a meal |
— | — | Acceptable for switch BHIVA ART 2025 §5.10 |
— | |
| CAB + RPV long-acting INSTI NNRTI 2-druglong-acting |
Vocabria 600 mg + Rekambys 900 mg IM (gluteal) at month 1 and 2, then every 2 months — or 400 mg + 600 mg monthly after initiation; optional oral lead-in with Vocabria 30 mg + Edurant 25 mg Not applicable (injection) |
— | — | Acceptable for switch BHIVA ART 2025 §5.10 |
— | |
| DRV/r + DTG PI INSTI 2-drug |
Prezista 800 mg + Norvir 100 mg once daily with food + Tivicay 50 mg once daily (twice daily dosing where resistance requires it) With food |
— | — | Acceptable for switch BHIVA ART 2025 §5.10 |
Alternative BHIVA ART 2025 §7.5 |
|
| DTG + AZT/3TC INSTI |
Tivicay 50 mg once daily + Combivir 300/150 mg twice daily With or without food |
— | — | — | Alternative BHIVA ART 2025 §7.5 |