5. The Integrase Era
The first HIV integrase inhibitor, Isentress (raltegravir), was approved in 2007, but the integrase era truly arrived in the past decade. In the latest HIV treatment guidelines, all of the initial regimens recommended for most people starting treatment include this class of antiretrovirals. Next-generation integrase inhibitors are highly potent and come with few side effects—or so it was thought. In 2018, researchers warned that dolutegravir (Tivicay, also included in the Triumeq, Juluca and Dovato combination pills) was linked to an increased risk of birth defects, although these fears later proved unfounded. More recently, new integrase inhibitors have been linked to weight gain, especially when taken with the updated version of tenofovir.
