Appendix B, Table 12. Antiretroviral Dosing Recommendations in Adults With Renal or Hepatic Insufficiency

Body
Generic Name
(Abbreviation)
Trade Name
Usual DoseaDosing in Adults With Renal InsufficiencyDosing in Adults With Hepatic Impairment

Recommendations for FDCs based on CrCl level are outlined in the table below.

NRTIs
Abacavir
(ABC)
Ziagen

ABC 300 mg PO twice daily

or

ABC 600 mg PO once daily

No dose adjustment necessary.

Child-Pugh Class A: ABC 200 mg PO twice daily (use oral solution)

Child-Pugh Class B or C: Contraindicated

Abacavir/Lamivudine
(ABC/3TC)
Epzicom
One tablet PO once daily

Not FDA recommended if CrCl <30 mL/min due to the 3TC component.

Note: There is insufficient evidence to recommend for or against the use of full-dose 3TC in people with CrCl <30 mL/min. Some Panel members use full-dose 3TC to allow people to remain on the FDC product. See the 3TC entry for more information.

Child-Pugh Class A: Patients with mild hepatic impairment require a dose reduction of ABC. Use the individual drugs instead of the FDC tablet in these patients.

Child-Pugh Class B or C: Contraindicated due to the ABC component

Emtricitabine
(FTC)
Emtriva

FTC 200-mg oral capsule once daily

or

FTC 240-mg (24-mL) oral solution once daily

Note: There is insufficient evidence to recommend for or against the use of full-dose, daily FTC in people with CrCl <30 mL/min who are not on HD. To allow people to remain on certain TAF-containing FDC products, some Panel members use full-dose, daily FTC in people with CrCl 15–‍29 mL/min who are not on HD.

Dose by Formulation

No dose recommendation.
CrCl (mL/min)CapsuleSolution
30–49bNo dose adjustment necessary.

15–29

(see Note)

200 mg every 72 hours

80 mg every 24 hours

<15 (not on HD)

(see Note)

200 mg every 96 hours

60 mg every 24 hours

On HDb

No dose adjustment necessary. On HD days, administer after dialysis.

Lamivudinec
(3TC)
Epivir

3TC 300 mg PO once daily

or

3TC 150 mg PO twice daily

Note: PK and safety data are limited on the use of 3TC doses higher than those recommended by the FDA in people with CrCl <30 mL/min. Clinicians may consider using the nearest available tablet strength (100 mg or 150 mg), as outlined in the “Alternative Dose” column (BIII) (see rationaled). There is insufficient evidence to recommend for or against the use of full-‍dose 3TC in people with CrCl <30 mL/min. Some Panel members use full-dose 3TC to allow people to remain on certain ABC and/or DTG-containing FDC products.

CrCl (mL/min)Epivir Label DoseAlternative DosedNo dose adjustment necessary

15–29

(see Note)

1 × 150 mg, then 100 mg every 24 hours

100–150 mg every 24 hours

5–14

(see Note)

1 × 150 mg, then 50 mg every 24 hours

100–150 mg every 24 hours

<5 or on HD

(see Note)

1 × 50 mg, then 25 mg every 24 hours

100–150 mg every 24 hours
Tenofovir Alafenamide
(TAF)
Vemlidy
Vemlidy is available as a 25-mg tablet for the treatment of HBV.CrCl (mL/min)Dose

Child-Pugh Class A: No dose adjustment

Child-Pugh Class B or C: Not recommended

<15 and not on HD

Not recommended

On HD

No dose adjustment necessary. On HD days, administer after dialysis.

Tenofovir Alafenamide/Emtricitabine
(TAF/FTC)
Descovy

TAF for HIV treatment is only available as a component of FDC tablets (i.e., in Descovy, Genvoya, Odefsey, Biktarvy, and Symtuza).

  • TAF 10 mg PO daily with EVG/c (Genvoya) or DRV/c (Symtuza)
  • TAF 25 mg PO daily in other FDC tablets
CrCl (mL/min)Dose

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No dose recommendation

15-29

Not recommended

Note: There is insufficient evidence to recommend for or against the use of full-dose, daily FTC in people with CrCl <30 mL/min. To allow people to remain on the FDC product, some Panel members use full-dose FTC in people with CrCl 15–29 mL/min.

<15 (not on HD)

Not recommended

On HD

No dose adjustment necessary. On HD days, administer after dialysis.

Tenofovir Disoproxil Fumarate
(TDF)
Viread
TDF 300 mg PO once dailyCrCl (mL/min)DoseNo dose adjustment necessary.

30–49

300 mg every 48 hours

10–29

300 mg twice weekly (every 72–96 hours)

<10 and not on HD

No recommendation

On HD

300 mg every 7 days (administer after completion of HD)

Tenofovir Disoproxil Fumarate/Emtricitabine
(TDF/FTC)
Truvada
One tablet PO once dailyCrCl (mL/min)DoseNo dose recommendation.

30–49

One tablet every 48 hours

<30 or on HD

FDC of TDF/FTC not recommended

Tenofovir Disoproxil Fumarate/Lamivudine
(TDF/3TC)
Cimduo
One tablet PO once dailyCrCl (mL/min)DoseNo dose recommendation.

<50 or on HD

FDC of TDF/FTC not recommended

NNRTIs
Doravirine
(DOR)
Pifeltro
DOR 100 mg PO once dailyNo dose adjustment required in mild, moderate, or severe renal impairment. Has not been studied in individuals with ESRD or on HD.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: Not studied

Doravirine/Tenofovir Disoproxil Fumarate/Lamivudine
(DOR/TDF/3TC)
Delstrigo
One tablet PO once dailyFDC of DOR/TDF/3TC not recommended if CrCl <50 mL/min or on HD

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: Not studied

Efavirenz
(EFV)
Sustiva
EFV 600 mg PO once daily on an empty stomach, preferably at bedtimeNo dose adjustment necessary.No dose recommendation; use with caution in patients with hepatic impairment.
Efavirenz/Tenofovir Disoproxil Fumarate/Emtricitabine
(EFV/TDF/FTC)
Atripla
One tablet PO once daily on an empty stomach, preferably at bedtimeFDC of DOR/TDF/3TC not recommended if CrCl <50 mL/min or on HDNo dose recommendation; use with caution in patients with hepatic impairment.
Efavirenz 600 mg/Tenofovir Disoproxil Fumarate/Lamivudine
(EFV/TDF/3TC)
Symfi
One tablet PO once daily on an empty stomach, preferably at bedtimeFDC of DOR/TDF/3TC not recommended if CrCl <50 mL/min or on HDNot recommended for patients with moderate or severe hepatic impairment. Use with caution in patients with mild hepatic impairment.
Efavirenz 400 mg/Tenofovir Disoproxil Fumarate/Lamivudine
(EFV/TDF/3TC)
Symfi Lo
One tablet PO once daily on an empty stomach, preferably at bedtimeFDC of DOR/TDF/3TC not recommended if CrCl <50 mL/min or on HDNot recommended for patients with moderate or severe hepatic impairment. Use with caution in patients with mild hepatic impairment.
Etravirine
(ETR)
Intelence
ETR 200 mg PO twice dailyNo dose adjustment necessary.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No dose recommendation

Rilpivirine
(RPV PO)
Edurant
RPV 25 mg PO once daily with foodNo dose adjustment necessary.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No dose recommendation

Rilpivirine IM plus Cabotegravir IM
(RPV IM and CAB IM)
Cabenuva

Monthly Dosing

  • Loading dose: RPV 900 mg/3 mL IM × 1 dose and CAB 600 mg/3 mL IM × 1 dose
  • Continuation phase: RPV 600 mg/2 mL IM every 4 weeks and CAB 400 mg/2 mL IM every 4 weeks

Every 2-month Dosing

  • Loading dose: RPV 900 mg/3 mL IM and CAB 600 mg/3 mL IM monthly for 2 doses
  • Continuation phase: RPV 900 mg/3 mL IM and CAB 600 mg/3 mL IM every 2 months

No dose adjustment necessary for mild or moderate renal impairment.

For patients with severe renal impairment or on HD, increase monitoring for adverse events.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No recommendation

Rilpivirine/Tenofovir Alafenamide/Emtricitabine
(RPV/TAF/FTC)
Odefsey
One tablet PO once daily with food

In People With CrCl 15–29 mL/min

  • Not recommended
  • Note: There is insufficient evidence to recommend for or against the use of full-dose, daily FTC in people with CrCl <30 mL/min. To allow people to remain on the FDC product, some Panel members use full-dose, daily FTC in people with CrCl 15–29 mL/min.

In People With CrCl <15 mL/min (not on HD)

  • Not recommended

In People on Chronic HD

  • No dose adjustment necessary. On HD days, administer after dialysis.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No dose recommendation

Rilpivirine/Tenofovir Disoproxil Fumarate/Emtricitabine
(RPV/TDF/FTC)
Complera
One tablet PO once daily with foodFDC of RPV/TDF/FTC not recommended if CrCl <50 mL/min or on HD

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No dose recommendation

Rilpivirine/Dolutegravir
(RPV/DTG)
Juluca
One tablet PO once daily with food

No dose adjustment necessary.

In patients with CrCl <30 mL/min, monitor closely for adverse effects.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No dose recommendation

PIs
Atazanavir
(ATV)
Reyataz

ATV 400 mg PO once daily with food

or

(ATV 300 mg plus RTV 100 mg) PO once daily with food

In People Without Prior ARV Treatment on HD

  • (ATV 300 mg plus RTV 100 mg) once daily with food

In ARV-Experienced People on HD

  • ATV and ATV/r are not recommended

Child-Pugh Class A: No dose adjustment

Child-Pugh Class B: ATV 300 mg once daily (unboosted) for ARV-naive patients only

Child-Pugh Class C: Not recommended

RTV boosting is not recommended in patients with hepatic impairment.

Atazanavir/Cobicistat
(ATV/c)
Evotaz
One tablet PO once daily with food

If Used with TDF

  • Not recommended if CrCl <70 mL/min
Not recommended in patients with hepatic impairment.
Darunavir
(DRV)
Prezista

In People Without Prior ARV Treatment or ARV- Experienced Treatment With No DRV Mutations

  • (DRV 800 mg plus RTV 100 mg) PO once daily with food.

In ARV-Experienced Patients with at Least One DRV Resistance Mutation

  • (DRV 600 mg plus RTV 100 mg) PO twice daily with food.
No dose adjustment necessary.

In People with Mild-to-Moderate Hepatic Impairment: No dose adjustment

In People with Severe Hepatic Impairment: Not recommended

Darunavir/Cobicistat
(DRV/c)
Prezcobix
One tablet PO once daily with food

If Used with TDF

  • Not recommended if CrCl <70 mL/min

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: Not recommended

Darunavir/Cobicistat/Tenofovir Alafenamide/Emtricitabine
(DRV/c/TAF/FTC)
Symtuza
One tablet PO once daily with food

In People With CrCl 15–29 mL/min

  • Not recommended
  • Note: There is insufficient evidence to recommend for or against the use of full-dose, daily FTC in people with CrCl <30 mL/min. To allow people to remain on the FDC product, some Panel members use full-dose, daily FTC in people with CrCl 15–29 mL/min.

In People With CrCl <15 mL/min (not on HD)

  • Not recommended

In People on Chronic HD

  • No dose adjustment necessary. On HD days, administer after dialysis.
Not recommended for patients with severe hepatic impairment.
Ritonavir
(RTV)
Norvir

As a PI-Boosting Agent

  • RTV 100–400 mg PO per day with food.
No dose adjustment necessary.Refer to recommendations for the primary (i.e., boosted) PI.
INSTIs
Bictegravir/Tenofovir Alafenamide/Emtricitabine
(BIC/TAF/FTC)
Biktarvy
One tablet PO once daily

In People With CrCl 15–29 mL/min

  • Not recommended
  • Note: There is insufficient evidence to recommend for or against the use of full-dose, daily FTC in people with CrCl <30 mL/min. To allow people to remain on the FDC product, some Panel members use full-dose, daily FTC in people with CrCl 15–29 mL/min.

In People With CrCl <15 mL/min (not on HD)

  • Not recommended

In People on Chronic HD

  • No dose adjustment necessary. On HD days, administer after dialysis

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: Not recommended

Cabotegravir
(CAB PO)
Vocabria

Treatment (As Optional Oral Lead-In or As Oral Bridging)

  • CAB 30 mg PO once daily, given with RPV 25 mg PO, with food before switching to CAB IM and RPV IM

Pre-exposure Prophylaxis (Optional Oral Lead-In)

  • CAB 30 mg PO once daily before switching to CAB IM
No dose adjustment necessary.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No recommendation

Cabotegravir
(CAB IM)
Apretude

Pre-exposure Prophylaxis

  • Loading dose: CAB 600 mg/3 mL IM monthly for 2 doses
  • Continuation phase: CAB 600 mg/3 mL IM every 2 months
No dose adjustment necessary.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No recommendation

Cabotegravir IM plus Rilpivirine IM
(CAB IM plus RPV IM)
Cabenuva

Monthly Dosing

  • Loading dose: CAB 600 mg/3 mL IM × 1 dose and RPV 900 mg/‌3 mL IM × 1 dose
  • Continuation phase: CAB 400 mg/2 mL IM every 4 weeks and RPV 600 mg/2 mL IM every 4 weeks

Every 2-month Dosing

  • Loading dose: CAB 600 mg/3 mL IM and RPV 900 mg/3 mL IM monthly for 2 doses
  • Continuation phase: CAB 600 mg/3 mL IM and RPV 900 mg/3 mL IM every 2 months

No dose adjustment necessary for mild or moderate renal impairment.

For patients with severe renal impairment or on HD, increase monitoring for adverse events.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No recommendation

Dolutegravir
(DTG)
Tivicay

DTG 50 mg PO once daily

or

DTG 50 mg PO twice daily

No dose adjustment necessary.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: Not recommended

Dolutegravir/Abacavir/Lamivudine
(DTG/ABC/3TC)
Triumeq
One tablet PO once daily

Not FDA recommended if CrCl <30 mL/min due to the 3TC component

Note: There is insufficient evidence to recommend for or against the use of full-dose 3TC in people with CrCl <30 mL/min. Some Panel members use full-dose 3TC to allow people to remain on the FDC product.d

Child-Pugh Class A: Patients with mild hepatic impairment require a dose reduction of ABC. Use the individual drugs instead of the FDC tablet in these patients.

Child-Pugh Class B or C: Contraindicated due to the ABC component

Dolutegravir/Lamivudine
(DTG/3TC)
Dovato
One tablet PO once daily

Not FDA recommended if CrCl <30 mL/min due to the 3TC component

Note: There is insufficient evidence to recommend for or against the use of full-dose 3TC in people with CrCl <30 mL/min. Some Panel members use full-dose 3TC to allow people to remain on the FDC product.d

Child-Pugh Class C: Not recommended
Dolutegravir/Rilpivirine
(DTG/RPV)
Juluca
One tablet PO once daily with food

No dose adjustment necessary.

In patients with CrCl <30 mL/min, monitor closely for adverse effects.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No dose recommendation

Elvitegravir/Cobicistat/Tenofovir Alafenamide/Emtricitabine
(EVG/c/TAF/FTC)
Genvoya
One tablet PO once daily with food

In People With CrCl 15–29 mL/min

  • Not recommended
  • Note: There is insufficient evidence to recommend for or against the use of full-dose, daily FTC in people with CrCl <30 mL/min. To allow people to remain on the FDC product, some Panel members use full-dose, daily FTC in people with CrCl 15–29 mL/min.

In People With CrCl <15 mL/min (not on HD)

  • Not recommended

In People on Chronic HD

  • No dose adjustment necessary. On HD days, administer after dialysis.

In People With Mild-to-Moderate Hepatic Insufficiency: No dose adjustment necessary 

In People With Severe Hepatic Insufficiency: Not recommended

Elvitegravir/Cobicistat/Tenofovir Disoproxil Fumarate/Emtricitabine
(EVG/c/TDF/FTC)
Stribild
One tablet PO once daily with food

EVG/c/TDF/FTC should not be initiated in people with CrCl <70 mL/min.

Discontinue EVG/c/TDF/FTC if CrCl declines to <50 mL/min while patient is on therapy.

In People with Mild-to-Moderate Hepatic Insufficiency: No dose adjustment necessary

In People with Severe Hepatic Insufficiency: Not recommended

Raltegravir
(RAL)
Isentress
Isentress HD

RAL 400 mg PO twice daily (using Isentress formulation)

or

RAL 1,200 mg PO once daily (using Isentress HD formulation only)

No dose adjustment necessary.

In People with Mild-to-Moderate Hepatic Insufficiency: No dose adjustment necessary

In People with Severe Hepatic Insufficiency: No recommendation

Fusion Inhibitor
Enfuvirtide
(T-20)
Fuzeon
T-20 90 mg SQ twice dailyNo dose adjustment necessary.No dose adjustment necessary.
CCR5 Antagonist
Maraviroc
(MVC)
Selzentry
The recommended dose differs based on concomitant medications and potential for drug-drug interactions. See Appendix B, Table 8 for detailed dosing information.

In People with CrCl <30 mL/min or People Who Are on HD

Without Potent CYP3A Inhibitors or Inducers

  • MVC 300 mg twice daily; if postural hypotension occurs, reduce to MVC 150 mg twice daily

With Potent CYP3A Inducers or Inhibitors

  • Not recommended
No dose recommendations. MVC concentrations will likely be increased in people with hepatic impairment.
CD4 Post-Attachment Inhibitor
Ibalizumab
(IBA)
Trogarzo

Loading dose: IBA 2,000 mg IV

Maintenance dose: IBA 800 mg IV every 2 weeks

No dose adjustment recommended.No recommendation.
gp-120 Attachment Inhibitor
Fostemsavir
(FTR)
Rukobia
FTR 600 mg PO twice dailyNo dose adjustment recommended.No dose adjustment recommended.
Capsid Inhibitor
Lenacapavir
(LEN)
Sunlenca

Initiation Option 1

  • Day 1: 927 mg SQ x 1 dose plus 600 mg PO x 1 dose
  • Day 2: 600 mg PO x 1 dose

Initiation Option 2

  • Day 1: 600 mg PO x 1 dose
  • Day 2: 600 mg PO x 1 dose
  • Day 8: 300 mg PO x 1 dose
  • Day 15: 927 mg SQ x 1 dose

Maintenance Dosing

  • 927 mg by SQ injection every 6 months from the date of the last injection (+/-‍2 weeks)
No dose adjustment recommended.

Child-Pugh Class A or B: No dose adjustment

Child-Pugh Class C: No recommendation

a Refer to Appendix B, Tables 1–10 for additional dosing information.

b The prescribing information for FTC (Emtriva) recommends adjusted doses for people with CrCl 30–49 mL/min and people on hemodialysis. However, the prescribing information for several FDC products that contain emtricitabine (including Descovy, Biktarvy, Genvoya, and Odefsey) recommends that the standard dose (emtricitabine 200 mg) can be given once daily in these patients (i.e., on the days of hemodialysis, administer standard dose after completion of dialysis). The recommendation in this table incorporates the dosing guidance from the FDC products.

c The prescribing information for 3TC recommends dosage adjustment from 300 mg once daily to 150 mg once daily for people with CrCl 30–49 mL/min. However, the prescribing information for several FDC products that contain 3TC (including Epzicom, Dovato, and Triumeq) recommends no dose adjustment for CrCl 30–49 mL/min. The recommendation in this table incorporates the dosing guidance from the FDC products.

d Use of 3TC doses higher than those recommended by the FDA for people with CrCl <30 mL/min has been reported in clinical practice 1-4 and endorsed in the Guidelines for Chronic Kidney Disease in People With HIV for many years 5; limited published literature has supported the safety of this practice 2,3. 3TC has a wide therapeutic index with no established correlation between elevated concentrations and AEs. Serious AEs, such as lactic acidosis and severe hematologic toxicities, have been reported in rare cases; however, these effects typically occurred in the setting of combination use with older NRTIs (such as didanosine, stavudine, zidovudine). Clinicians may consider using the nearest available tablet strength (100 mg or 150 mg) to avoid the need for 3TC oral solution, thereby simplifying ARV regimens and facilitating adherence (BIII). See the Alternative Dose column in 3TC table entry. There is insufficient evidence to recommend for or against the use of full-dose 3TC in people with CrCl <30 mL/min. Some Panel members use full-dose 3TC to allow people to remain on certain FDC products.

Key: 3TC = lamivudine; ABC = abacavir; ATV = atazanavir; ATV/c = atazanavir/cobicistat; ATV/r = atazanavir/ritonavir; BIC = bictegravir; CAB = cabotegravir; COBI = cobicistat; CrCl = creatinine clearance; CYP = cytochrome P; DOR = doravirine; DRV = darunavir; DRV/c = darunavir/cobicistat; DTG = dolutegravir; EFV = efavirenz; ESRD = end stage renal disease; ETR = etravirine; EVG = elvitegravir; EVG/c = elvitegravir/cobicistat; FDC = fixed-dose combination; FTC = emtricitabine; FTR = Fostemsavir; HBV = hepatitis B virus; HD = hemodialysis; IBA = ibalizumab; IM = intramuscular; INSTI = integrase strand transfer inhibitor; IV = intravenous; LEN = lenacapavir; LPV = lopinavir; LPV/r = lopinavir/ritonavir; MVC = maraviroc; NNRTI = non-nucleoside reverse transcriptase inhibitor; NRTI = nucleoside reverse transcriptase inhibitor; NVP = nevirapine; PI = protease inhibitor; PO = orally; RAL = raltegravir; RPV = rilpivirine; RTV = ritonavir; SQ = subcutaneous; T 20 = enfuvirtide; TAF = tenofovir alafenamide; TDF = tenofovir disoproxil fumarate; XR = extended release

 

Creatinine Clearance Calculation

Male:

[(140 - age in years) x (weight in kg)] / [72 x (serum creatinine)]

Female:

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Child-Pugh Score
ComponentPoints Scored
123
EncephalopathyaNoneGrade 1–2Grade 3–4
AscitesNoneMild or controlled by diureticsModerate or refractory despite diuretics
Albumin>3.5 g/dL2.8–3.5 g/dL<2.8 g/dL
Total Bilirubin, or<2 mg/dL (<34 µmol/L)2–3 mg/dL (34–50 µmol/L)>3 mg/dL (>50 µmol/L)
Modified Total Bilirubinb<4 mg/dL4–7 mg/dL>7 mg/dL
Prothrombin Time (Seconds Prolonged), or<44–6>6
International Normalized Ratio (INR)<1.71.7–2.3>2.3

a Encephalopathy Grades

Grade 1: Mild confusion, anxiety, restlessness, fine tremor, slowed coordination

Grade 2: Drowsiness, disorientation, asterixis

Grade 3: Somnolent but rousable, marked confusion, incomprehensible speech, incontinence, hyperventilation

Grade 4: Coma, decerebrate posturing, flaccidity

b Modified total bilirubin is used for patients who have Gilbert’s syndrome or who are taking atazanavir.

 

Child-Pugh ClassificationTotal Child-Pugh Scorea
Class A5–6 points
Class B7–9 points
Class C>9 points
a Sum of points for each component of the Child-Pugh Score.

 

Back to Appendix B

References

  1. Bohjanen P, Johnson M, Szczech L, et al. Steady-state pharmacokinetics of lamivudine in human immunodeficiency virus-infected patients with end-stage renal disease receiving chronic dialysis. Antimicrob Agents Chemother. 2002;46(8):2387-2392. Available at: https://pubmed.ncbi.nlm.nih.gov/12121909.
  2. Fischetti B, Shah K, Taft D, Berkowitz L, Bakshi A, Cha A. Real-world experience with higher-than-recommended doses of lamivudine in patients with varying degrees of renal impairment. Open Forum Infect Di 2018;5(10):ofy225. Available at: https://pubmed.ncbi.nlm.nih.gov/30302352.
  3. Michienzi S, Schriever C, Badowski M. Abacavir/lamivudine/dolutegravir single tablet regimen in patients with human immunodeficiency virus and end-stage renal disease on hemodialysis. Int J STD AIDS. 2019;30(2):181-187. Available at: https://pubmed.ncbi.nlm.nih.gov/30381029.
  4. Wood B, Pozniak A. Dosing lamivudine or emtricitabine in renal impairment: new data confirm it's time for updated guidance! AID 2021;35(8):1305-1307. Available at: https://pubmed.ncbi.nlm.nih.gov/34076616.
  5. Lucas G, Ross M, Stock P, et al. Clinical practice guideline for the management of chronic kidney disease in patients infected with HIV: 2014 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(9):e96-e138. Available at: https://academic.oup.com/cid/article/59/9/e96/422813.