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Decision Support Summary: Initial Oral ART With 2DR vs 3DR by Clinical Scenario

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When can 2-drug regimens (2DRs) vs 3-drug regimens (3DRs) be considered for initial ART? In many scenarios, modern 2DRs are noninferior to 3DR alternatives. This reference reviews key clinical scenarios and outlines when to consider one vs the other.

Released: September 29, 2026

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Provided by Clinical Care Options, LLC dba Decera Clinical Education

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Supporters

This activity is supported by an educational grant from ViiV Healthcare.

ViiV Healthcare

Target Audience

This activity is intended for physicians (including HIV/infectious disease specialists, primary care physicians, and internists), nurse practitioners, physician assistants, pharmacists, and other healthcare professionals involved in the initiation of antiretroviral therapy in adults living with HIV.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Integrate the clinical evidence, including results from VOGUE and other key trials and real-world studies, to make informed, evidence-based decisions about the comparative merits of 2DR and 3DR for ART initiation

  • Apply evidence-based clinical frameworks to select between 2DR and 3DR across a range of commonly encountered first-line ART scenarios, and communicate the rationale for 2DR confidently in shared decision-making conversations with patients

Financial Disclosures

Primary Author

Luis Buzón Martin, MD: consultant/advisor/speaker: ViiV.

Pedro Cahn, MD, PhD: consultant/advisor/speaker: ViiV; researcher: Gilead, MSD.

Charlotte-Paige Rolle, MD, MPH: consultant/advisor/speaker: Gilead, Theratechnologies, ViiV; researcher: Gilead, MSD, ViiV.