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lamivudine + zidovudine + abacavir (abacavir + Combivir / Combivir + abacavir / Trizivir)

✓ Approved

Shire · · Small Molecule

What is lamivudine + zidovudine + abacavir?

lamivudine + zidovudine + abacavir is a small molecule developed by Shire. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namesabacavir + Combivir, Combivir + abacavir, Trizivir
CompanyShire
Drug ClassSmall Molecule
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Shire

Mechanism of Action

Molecular Targets

lamivudine + zidovudine + abacavir acts on 1 molecular target:

gag-pol, HIV-1 (gag-pol)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

lamivudine + zidovudine + abacavir is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Infections and infestationsAcquired immunodeficiency syndrome✓ Approved

Related Research Articles

PubMedAnnals of vascular surgery2026-05-24

Integrated multi-omics reveals key drivers and immune cell phenotypes of infrapopliteal atherosclerosis and calcification.

Li Xiaodong X, Huang Yao Y, Yu Yihan Y, Zheng Xu X et al.

Infrapopliteal atherosclerosis and calcification are major causes of chronic limb ischemia. This study aimed to identify causative genes and immune cell phenotypes driving this pathology to develop targeted therapeutic strategies. Bulk RNA transcriptomics (bulk RNA-seq) and summary data-based Mendelian randomization (SMR) were integrated to identify key genes associated with infrapopliteal atherosclerosis. Subsequently, single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics (ST) were employed to characterize the target gene's specific expression and spatial distribution in calcified vessels. Mendelian randomization (MR) combined with scRNA-seq was utilized to identify immune cell phenotypes causally associated with the disease. Molecular mechanisms were investigated via in silico knockout and protein-protein interaction analyses, followed by therapeutic drug prediction via enrichment analysis. Integrated analysis identified HLA-B as the robust causative gene for infrapopliteal atherosclerosis (PSMR = 0.002, β = 0.274). scRNA-seq analysis showed that HLA-B was significantly upregulated in B cells in calcified vascular tissue. Additionally, MR analysis combined with scRNA-seq identified IgD- CD27- B cell %B cell and IgD+ CD24- B cell %lymphocyte as immune cell phenotypes causally associated with the disease. In silico knockout combined with protein docking revealed a strong interaction between HLA-B and MRPL18, and ST analysis demonstrated higher overall expression of HLA-B in calcified vessels, particularly in plaques and calcified regions. Drug enrichment analysis suggested that allopurinol, abacavir, and lamotrigine could be potential therapeutics targeting HLA-B. Integrated multi-omics revealed HLA-B upregulation drives infrapopliteal atherosclerosis and calcification, identifying IgD- CD27- B cell %B cell and IgD+ CD24- B cell %lymphocyte as causal immune phenotypes.

PMID 42176975
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PubMedInfectious diseases and therapy2026-05-24

HBV Serological Profiles and Vaccination Status in People with HIV in the Transition to a Tenofovir-Sparing Era: Insights from a Large HIV Cohort.

Foncillas Alberto A, De La Mora Lorena L, Berrocal Leire L, de Lazzari Elisa E et al.

The increasing adoption of tenofovir (TXF)-sparing antiretroviral therapy (ART) raises concerns regarding hepatitis B virus (HBV) susceptibility and reactivation risk among people with HIV (PWH). We characterized HBV serological profiles and vaccination status according to ART composition in a real-world cohort. A cross-sectional study of all PWH in active follow-up at Hospital Clínic, Barcelona, as of 30 June 2025. ART regimens were categorized as TXF-containing or TXF-sparing, with or without lamivudine (3TC). HBV serological patterns were classified as chronic infection, serologically resolved infection, isolated HBV core antibody (anti-HBc), no exposure/immunity, and vaccine-induced immunity. Demographic and clinical characteristics were compared using nonparametric and chi-squared/Fisher's tests. Among the 6437 participants included (82% cisgender men; median age 48 years [IQR 39-58]), 3519 (55%) received TXF-containing and 2918 (45%) TXF-sparing regimens, of whom 1702/2918 (58%) were with 3TC. HBV serological distribution was: 2% chronic infection, 26% serologically resolved infection, 5% isolated anti-HBc, 52% vaccine-induced immunity, and 15% without exposure/immunity (50% documented prior vaccination attempts, 32% nonresponders, and 31% with prior anti-HBs detection). Overall, 1280 (20%) lacked protective HBV immunity (isolated anti-HBc or negative serology for all markers), including 530 (41%) on TXF-free regimens. TXF recipients were younger (47 versus 50 years, p < 0.001), more often migrants (58% versus 49%, p < 0.001), had lower suppression rates (91% versus 97%, p < 0.001), a higher proportion of previous virological failure(s) (26% versus 21%, p < 0.001), and a lower number of prior ART regimens (median 3 versus 4, p < 0.001). One in five PWH lacked effective HBV immunity, including 41% of whom were receiving TXF-sparing strategies. In the context of increasing use of TXF-sparing strategies, improvements in systematic HBV screening, vaccination, and risk-based monitoring are essential to prevent HBV-related morbidity.

PMID 42176113
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PubMedCureus2026-05-22

Neonatal Lactic Acidosis Associated With Antiretroviral Exposure: A Case Report.

Mercado Joanna J, Rivera Laiza L, Droz López Aisha A, Poventud Yolymar Y et al.

Antiretroviral therapy (ART) prophylaxis in infants born to mothers with human immunodeficiency virus (HIV) has significantly reduced vertical transmission rates; however, these medications may cause severe adverse effects, including lactic acidosis. We present the case of a seven-day-old boy born at 37 weeks to an HIV-positive mother who presented to the emergency department with persistent irritability. The patient was receiving HIV prophylaxis with lamivudine, zidovudine, and nevirapine. He demonstrated persistent tachycardia despite an otherwise reassuring physical examination. Laboratory evaluation revealed elevated serum lactate levels with worsening hyperlactatemia on serial measurements. In coordination with the Infectious Disease team, the ART regimen was modified to raltegravir and lamivudine, resulting in metabolic improvement. This case underscores the importance of recognizing ART-related toxicity in neonates with progressive hyperlactatemia despite initially subtle clinical manifestations, prompting early treatment readjustment and close monitoring.

PMID 42170364
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PubMedOpen forum infectious diseases2026-05-22

Risk of Developing Low-Level Viral Rebound Among People With HIV Receiving 2- or 3-Drug Regimens: A Case-Control Study Nested in the ICONA Cohort.

Vergori Alessandra A, Cervo Adriana A, Roen Ashley A, Gagliardini Roberta R et al.

The risk of developing low-level viral rebound (LLVR) after achieving human immunodeficiency virus HIV-1 (HIV) RNA suppression with 2-drug regimens (2DR) compared to 3-drug regimens (3DR) remains uncertain. We conducted a matched 1:3 case-control study nested within the ICONA cohort including persons with HIV (PWH) who achieved virological suppression (≥2 consecutive HIV-RNA ≤50 copies/mL over 6 months) after 11 November 2014 (baseline [BL]). Cases were defined as PWH experiencing a single HIV-RNA of 51-199 copies/mL after BL (index date); controls were defined as those who maintained HIV-RNA ≤50 copies/mL up to the index date and were matched for history of care gaps and number of drugs failed. The cumulative incidence of LLVR after virological suppression was estimated using Kaplan-Meier methods, and conditional logistic regression models were used to evaluate the association between the current antiretroviral therapy regimen (2DR [dolutegravir/lamivudine, dolutegravir/rilpivirine, dolutegravir/doravirine, or cabotegravir/rilpivirine] vs 3DR [dolutegravir, bictegravir, rilpivirine, doravirine, boosted darunavir, or boosted atazanavir-based with a backbone of tenofovir and lamivudine or emtricitabine]) and LLVR risk. In sensitivity analyses cases were defined as PWH experiencing 2 consecutive HIV-RNA of 51-199 copies/mL. Among 1033 PWH (261 cases, 772 matched controls), 21% were female, median age was 43 (interquartile range [IQR], 34-51) years, and BL CD4 count was 601 (IQR, 379-826) cells/μL; 2DR use was 25% in cases versus 29% in controls (P = .23). Two years after viral suppression, cumulative LLVR incidence was 2.7% (95% CI, 2.3%-3.1%) when considering single LLVR events and 1.8% (95% CI, 1.4%-2.1%) when limited to 2 consecutive values. After adjusting for confounding, evidence for an association with current regimen was inconclusive (adjusted odds ratio, 0.86 [95% CI, .57-1.29]). Despite the wide range of plausibility, we can exclude a risk of LLVR higher than 29% when using 2DR versus 3DR regimens.

PMID 42169694
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PubMedInfectious diseases and therapy2026-05-21

Efficacy and Safety of Switching to Dolutegravir/Lamivudine in Virologically Suppressed HIV-1 Infected Adults with TDF-Related Renal or Bone Toxicity.

Wang Zhenyan Z, Liu Li L, Chen Jun J, Wang Jiangrong J et al.

Long-term use of tenofovir disoproxil fumarate (TDF) is associated with renal tubular dysfunction and bone mineral loss. In virologically suppressed people living with HIV (PLWH), optimizing antiretroviral therapy requires maintaining viral suppression while minimizing cumulative drug-related toxicity. We therefore evaluated the efficacy and safety of switching to dolutegravir/lamivudine (DTG/3TC) in Chinese PLWH with TDF-related renal or bone toxicity. This prospective, single-center, open-label cohort study enrolled adults with HIV-1 RNA < 40 copies/ml for ≥ 6 months on TDF-based regimens and evidence of TDF-associated renal or bone toxicity. Participants were switched to DTG/3TC and followed for 48 weeks. The primary endpoint was virological failure at week 48 (FDA Snapshot algorithm). Secondary endpoints included changes in CD4 + T-cell counts, renal tubular biomarkers, bone mineral density (BMD), metabolic parameters, and safety outcomes. One hundred participants were enrolled; 91 completed the study per protocol. Median age was 45 years and 90% were male. At week 48, virological suppression was maintained in 90% of the intention-to-treat-exposed population and 99% of the per-protocol population. CD4 + T-cell counts increased significantly at week 48 (+ 77.4 cells/μl; p < 0.001). Markers of proximal tubular dysfunction improved significantly, including reductions in urinary β2-microglobulin-to-creatinine ratio, urine albumin-to-creatinine ratio, and urinary retinol-binding protein-to-creatinine ratio (all p < 0.001). BMD increased in the lumbar spine and hip (both p < 0.001). Modest weight gain (+ 2.17 kg) and small increases in total cholesterol and low-density lipoprotein cholesterol were observed at week 48. In virologically suppressed Chinese PLWH with TDF-related renal or bone toxicity, switching to DTG/3TC maintained viral suppression and was associated with significant improvements in renal tubular and bone metabolic markers over 48 weeks. DTG/3TC represents a well-tolerated toxicity-driven switch strategy in routine clinical practice. ClinicalTrial.gov ID: NCT05493969.

PMID 42162408
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PubMedEClinicalMedicine2026-05-21

Perinatal outcomes associated with antiretroviral therapy for pregnant women living with HIV: an umbrella review.

Boering Pippa Huete PH, Hemelaar Joris J

The World Health Organization recommends antiretroviral therapy (ART) for pregnant women living with HIV (WLHIV), the vast majority of whom reside in sub-Saharan Africa. In recent years, many systematic reviews, meta-analyses, and randomised controlled trials (RCTs) have been performed to assess the risks of adverse perinatal outcomes associated with ART among WLHIV. The aim of this umbrella review is to assess the available evidence regarding the risks of adverse perinatal outcomes for WLHIV receiving ART. We conducted a systematic literature review by searching Medline, Global Health, and EMBASE and two clinical trial databases (ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform) for meta-analyses and RCTs published between 1 January 1980 and 12 February 2026. We included meta-analyses and RCTs reporting on the association of pregnant WLHIV receiving ART with perinatal outcomes, compared to WLHIV receiving different ART regimens, WLHIV naïve to ART, and women without HIV. We also included studies that assessed the timing of ART initiation (preconception or antenatal). Twelve predefined perinatal outcomes were assessed: preterm birth (PTB), very PTB (VPTB), spontaneous PTB (sPTB), low birthweight (LBW), very LBW (VLBW), term and preterm LBW, small for gestational age (SGA), very SGA (VSGA), stillbirth, neonatal death, and vertical HIV transmission. Heterogeneity measures (I 2 ) and Peter's test results for publication bias were extracted and assessed. The quality of meta-analyses was assessed using the AMSTAR 2 tool, risk of bias of RCTs was assessed using the Cochrane Risk of Bias tool, and overall certainty of evidence for each exposure comparison and perinatal outcome was assessed according to GRADE. The protocol is registered with PROSPERO, number CRD42021248987. Of 14,279 studies identified, we included nine meta-analyses of cohort studies, one network meta-analysis of seven RCTs, and three additional RCTs. The meta-analyses were composed of a total of 154 cohort studies and were of low or critically low quality, and RCTs had a high risk of bias. Meta-analyses of cohort studies found that WLHIV receiving ART are at increased risks of PTB (risk ratio (RR) 1.55, 95% confidence interval (CI) 1.38-1.74, I 2 87.4%), sPTB (RR 2.10, 95% CI 1.48-2.96, I 2 12.5%), LBW (RR 1.79, 95% CI 1.51-2.13, I 2 90.6%), term LBW (RR 1.88, 95% CI 1.23-2.85, I 2 0.0%), SGA (RR 1.80, 95% CI 1.34-2.40, I 2 97.6%), and VSGA (RR 1.22, 95% CI 1.10-1.34, I 2 0.0%), compared to HIV-negative women. RCTs comparing ART regimens among WLHIV found few differences in perinatal outcomes assessed. Meta-analyses of cohort studies comparing different ART regimens found that protease inhibitors are associated with an increased risk of SGA (RR 1.28, 95% CI 1.09-1.51, I 2 62.2%) and VSGA (RR 1.41, 95% CI 1.08-1.83, I 2 0.0%), compared to non-nucleoside reverse transcriptase inhibitors. Tenofovir disoproxil fumarate is associated with a lower risk of adverse perinatal outcomes and zidovudine is associated with an increased risk of perinatal outcomes. Compared to HIV-negative women, WLHIV receiving ART remain at increased risk of adverse perinatal outcomes, irrespective of the ART regimen and timing of ART initiation. Publication bias, as determined using the Peter's test, was found for two analyses. Most findings were of low or very low certainty as assessed using GRADE. WLHIV receiving ART are associated with increased risks of adverse perinatal outcomes compared to HIV-negative women, irrespective of the ART regimen and timing of ART initiation. To strengthen the evidence base for ART guidelines for pregnant WLHIV, more and larger RCTs and high quality observational studies are needed to optimise ART regimens in pregnancy. Further efforts should be made to improve perinatal outcomes among WLHIV. This study received no funding.

PMID 42163971
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