priors.science/reviews/hiv-pharmacotherapy

Hiv Pharmacotherapy

The current evidence on 16 claims, ordered from most established to most contested. Each score is the panel’s evidence certainty — how firmly the literature supports the claim as stated.

16claims tracked
107primary papers reviewed
6 Jul 2026latest evidence review
Weeklyre-scored against new papers
8 Established · 6 Likely · 2 Uncertain · 0 Doubtful  |  four-reviewer panel · PICO Framework
SignalClaimStandingEvidence certaintyCorpus
StablePeople living with HIV on effective ART with an undetectable viral load do not transmit HIV sexually (U=U: Undetectable = Untransmittable), as demonstrated across multiple large prospective studies.Treatment As PreventionEstablished95%7
StableAntiretroviral therapy (ART) suppresses HIV viral load to undetectable levels in the majority of adherent patients, restores CD4 count, and prevents AIDS-defining illness and death.Art SuppressionEstablished93%7
StableDolutegravir-based regimens are superior or non-inferior to other antiretroviral classes as first-line therapy in terms of virological suppression, tolerability, and barrier to resistance.Integrase InhibitorsEstablished93%7
StableDaily oral tenofovir-based pre-exposure prophylaxis (PrEP) reduces HIV acquisition risk by 99% in adherent individuals, with effectiveness dependent on adherence.Treatment As PreventionEstablished93%7
StableTwo-drug regimens (dolutegravir/lamivudine; dolutegravir/rilpivirine) are non-inferior to standard three-drug regimens for virologically suppressed patients and reduce drug burden without compromising efficacy.Art SuppressionEstablished92%7
StableBictegravir/tenofovir alafenamide/emtricitabine (B/F/TAF) provides high virological suppression rates with a favourable metabolic and renal safety profile compared to older tenofovir disoproxil fumarate-based regimens.Integrase InhibitorsEstablished92%7
StableSwitch from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) reduces renal tubular toxicity and improves bone mineral density but is associated with greater weight gain and lipid elevation.Comorbidity ManagementEstablished91%7
StableLong-acting cabotegravir/rilpivirine (every 2 months) is non-inferior to daily oral ART for maintaining virological suppression in stable patients, with improved adherence-related outcomes.Long Acting FormulationsEstablished91%7
StableLong-acting injectable lenacapavir every 6 months is highly effective as PrEP in cisgender women (PURPOSE 1 trial), representing a paradigm shift in HIV prevention options.Emerging ApproachesLikely79%6
StablePeople living with HIV on stable ART have substantially higher rates of cardiovascular disease, metabolic syndrome, and chronic kidney disease compared to age-matched HIV-negative individuals, attributable to HIV-related inflammation and antiretroviral toxicity.Comorbidity ManagementLikely77%7
StableIntegrase strand transfer inhibitor (INSTI) resistance is uncommon with dolutegravir-based first-line therapy in treatment-naive patients due to the high genetic barrier to resistance of dolutegravir and bictegravir.Drug ResistanceLikely77%6
StableIntegrase inhibitors (particularly dolutegravir and bictegravir) are associated with greater weight gain after ART initiation compared to other antiretroviral classes, with the mechanism not fully established.Comorbidity ManagementLikely76%6
StableLenacapavir (every 6 months subcutaneous injection) in combination with other agents provides virological suppression in treatment-experienced patients with multidrug-resistant HIV.Long Acting FormulationsLikely76%6
StableTransmitted drug resistance (TDR) to INSTIs is increasing in some settings but remains below 5% globally, and pre-treatment resistance testing is recommended before initiating first-line therapy in high-prevalence settings.Drug ResistanceLikely75%6
StableBroadly neutralising antibodies (bNAbs) in combination can suppress HIV viral load in some patients and represent a pathway toward functional cure strategies, though current evidence is from early-phase trials.Emerging ApproachesUncertain51%6
StableHIV cure strategies targeting the latent reservoir (including shock-and-kill, block-and-lock, and gene therapy approaches) have not achieved durable HIV remission in the absence of ART in clinical trial settings.Emerging ApproachesUncertain51%6
Standing — what the evidence certainty means
Established≥ 85%Strong, consistent evidence. Unlikely to change.
Likely65–84%Well supported, with some gaps or indirect evidence.
Uncertain40–64%Mixed or limited evidence. Genuinely open.
Doubtful15–39%Little support; the weight of evidence leans against it.
Refuted< 15%The evidence contradicts it — confidently false as stated.
Recent signal
strengthenedNew evidence raised the certainty since the last review.
weakenedNew evidence lowered the certainty since the last review.
newA claim added to the review recently.
StableNo recent change to the standing.
Standing, evidence certainty and corpus are always shown. The study behind each move, why it moved, and the sceptic’s challenge are delivered to subscribers.
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