Biktarvy is a fixed-dose combination formulation containing bictegravir, emtricitabine, and tenofovir alafenamide, providing a brand-new treatment option for people living with HIV.

What Are the Precautions for Using Biktarvy (Biktarvy)?

Patients with Hepatic Dysfunction

For HIV patients coinfected with hepatitis B virus, abrupt discontinuation of Biktarvy may lead to acute exacerbation of hepatitis, and in severe cases, hepatic decompensation may occur.

Such patients need to receive clinical and laboratory monitoring for at least several months after drug withdrawal.

If signs of hepatic function deterioration appear, anti-hepatitis B treatment should be initiated promptly.

Patients with Renal Insufficiency

Medication should be administered differently according to the creatinine clearance rate.

Patients with a creatinine clearance rate ≥30 mL/min can use the standard dose, while the use of Biktarvy is not recommended for patients with a creatinine clearance rate of 15-30 mL/min or those with end-stage renal disease.

It should be particularly noted that the risk of renal-related adverse reactions is significantly increased in patients who have recently used nephrotoxic drugs (such as high-dose nonsteroidal anti-inflammatory drugs).

During treatment, regular monitoring of serum creatinine, urine glucose, and urine protein indicators is required.

Contraindicated Concomitant Medications

Dofetilide: Co-administration may increase its plasma concentration and trigger severe adverse events.

Rifampicin: It can significantly reduce the plasma concentration of bictegravir.

Aluminum/magnesium-containing antacids should be taken 2 hours before or 6 hours after Biktarvy administration.

Calcium or iron supplements should be taken with food when co-administered with Biktarvy.

Medication Monitoring for Biktarvy (Biktarvy)

Baseline Examinations Before Treatment

Screening for hepatitis B virus infection.

Evaluation of serum creatinine and creatinine clearance rate.

Detection of urine glucose and urine protein.

For patients with chronic kidney disease, additional serum phosphorus testing is required.

Regular Monitoring During Treatment

All patients should undergo continuous monitoring of serum creatinine, creatinine clearance rate, urine glucose, and urine protein indicators based on clinical needs.

Enhanced Monitoring for Special Cases

During the initial stage of combined antiretroviral therapy, patients may develop immune reconstitution inflammatory syndrome, requiring further evaluation and treatment of latent infections.