Evolution of antiretroviral therapy: Transitioning from three-drug to two-drug HIV regimens

The field of HIV treatment has witnessed a significant transformation since the mid-1990s with the introduction of combination antiretroviral therapy (cART). Traditionally, a three-drug regimen has played a crucial role in improving both survival and quality of life for people living with HIV. However, chronic exposure raises various challenges, including toxicity, adherence issues, resistance development, and financial constraints. Recent strides in pharmacology have led to the advent of effective two-drug regimens that have demonstrated similar levels of viral suppression with comparable clinical outcomes. This evolution toward treatment simplification is a response to the need for better drug tolerability and a comprehensive understanding of viral-host interactions. The shift necessitates evaluating the scientific basis and practical outcomes of these dual therapies.

This Research Topic aims to delve into the transition from three-drug to two-drug antiretroviral regimens, investigating their efficacy, safety, and impact on disease management. We seek to assess the effects of dual therapies on immune restoration, inflammation, and viral reservoirs, as well as their roles in managing co-morbidities and achieving long-term disease control. The objective is to create a dialogue around the mechanisms that underpin simplified treatments, bridging clinical insights and basic research perspectives. By doing so, we aim to refine strategies for HIV management and harness the potential of pharmacological innovations.

Focusing on the interface between antiretroviral therapy and host immune response, we are seeking articles that address a variety of topics within defined boundaries. Themes of interest include:
o Immune reconstitution under dual therapy
o Virologic suppression and rebound risks
o Inflammation and immune activation markers
o Latent reservoir dynamics
o Resistance development and drug-drug interactions
o Real-world effectiveness and population-specific outcomes

We encourage submissions in various formats, including original research, reviews, perspectives, and brief communications. Contributions should be pertinent to virus-host immunity and aim to inform future directions for optimizing HIV treatment. Multidisciplinary approaches and translational research are particularly valued for their potential to impact public health policy and practices.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Conceptual Analysis
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Conceptual Analysis
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: HIV, combination Antiretroviral Therapy (cART), Two and Three Drug Regimens (2DR and 3DR), Inflammation and Immune Activation, Viral Reservoir

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.