Over the last decade, according to international guidelines [1,2], integrase strand transfer inhibitors have become the cornerstone of modern antiretroviral regimens for the treatment of people living with human immunodeficiency virus (PLWHIV). The second-generation INSTIs, bictegravir (BIC) and dolutegravir (DTG), have rapidly become the most commonly used ‘third’ agents in standard first-line three-drug regimens due to their excellent efficacy, high genetic barrier and favourable safety profile, as shown in clinical trials [3], [4], [5]. In clinical practice, DTG has been utilized in first-line regimens as part of a three-drug regimen with a two nucleoside reverse transcriptase inhibitor (NRTI) backbone, and as part of a two-drug regimen with lamivudine [6,7]. BIC is currently available exclusively in a single tablet regimen (STR) in association with FTC and TAF, with favourable outcomes also emerging from clinical practice [8].

This multi-centre study aimed to analyse and compare the efficacy and safety of BIC and DTG when prescribed in association with FTC/TAF as part of a first-line regimen for the treatment of HIV-1 infection.