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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

PubMedFrontiers in public health2026-07-23

HIV viral suppression outcomes of Tenofovir- and Abacavir-based antiretroviral regimens among children on ART in Zambia.

Gwasupika Jonathan J, Magura Judie J, Phiri Lewis L, Chikwanda Ephraim E et al.

Use of ART has remarkably decreased HIV related morbidity and mortality rates globally. Children living with HIV in Zambia are initiated on an Abacavir-based regimen to suppress viral replication. This study assessed the achievement of HIV viral suppression among children taking Abacavir and Tenofovir-based regimens and the predicting factors associated with viral load suppression in Zambian children. This was a retrospective cross-sectional analysis of routinely collected data on all children diagnosed with HIV aged below 15 years attending the ART clinic from 1 January 2016 to 31 December 2018 at the Paediatric University Teaching Hospital in Lusaka, Zambia. Logistic regression was used to explore factors associated with HIV virological suppression. Ethical approval for the study was sought from the University of Zambia Biomedical Research Ethical Committee and the National Health Research Authority. About 78.4% of children on ART achieved virological suppression (262/334). An increase in age showed about 20% reduced odds of virological suppression (AOR 0.80, CI 0.71-0.95), while a child on ABC/3TC/LPV-r combination of ART compared to TDF/XTC/DTG, showed about 88% reduced odds of virological suppression (AOR 0.12, CI 0.04-0.41). Despite an increased uptake of ART, the viral suppression found in this study was lower than the UNAIDS target of 95% of people on ART to be virally suppressed. Greater sensitization and education on the importance of treatment adherence are required to achieve this target, and further studies are needed to determine the factors contributing to the low viral load suppression in children.

PMID 42487809
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PubMedValue in health regional issues2026-07-22

Cost-Utility Analysis of Dolutegravir Versus Efavirenz-Based Regimens for HIV Treatment in Indonesia: A Model-Based Extrapolation From Primary Healthcare Settings.

Zakiyah Neily N, Iftinan Ghina Nadhifah GN, Nuraeni Sani S, Sinuraya Rano Kurnia RK et al.

Dolutegravir-based therapy (tenofovir/lamivudine/dolutegravir [TLD]) is recommended by the World Health Organization as the preferred first-line regimen for HIV treatment due to its superior efficacy and safety profile. However, local economic evidence supporting this recommendation in Indonesia remains limited. This study evaluated the cost utility of TLD compared with efavirenz-based therapy (tenofovir/lamivudine/efavirenz [TLE]) using real-world data from primary healthcare settings. A Markov model was developed to estimate lifetime costs and health outcomes of TLD and TLE from the healthcare payer's perspective. The model included 3 mutually exclusive health states: suppressed, unsuppressed, and death. Primary data on treatment outcomes were collected from multiple primary healthcare facilities in Bandung, Indonesia. Costs included drug acquisition and routine monitoring based on national tariffs. Costs and outcomes were discounted at 3% annually. Deterministic, probabilistic, and scenario analyses were conducted to assess uncertainty. In the base case, TLD was less costly and more effective than TLE, indicating dominance. Probabilistic sensitivity analysis demonstrated decision uncertainty, with simulations distributed across cost-effectiveness quadrants, although TLD was favored in most iterations. The cost-effectiveness acceptability curve showed a probability exceeding 90% across commonly used thresholds. Scenario analysis incorporating resistance-related switching produced consistent findings, with TLD remaining economically favorable. Results were most sensitive to treatment costs and baseline viral suppression. At a benchmark of approximately 1 × gross domestic product per capita (≈IDR 83 to 84 million per quality-adjusted life-years), TLD remained economically favorable. TLD is likely to be cost-effective for HIV management in Indonesia, while acknowledging decision uncertainty.

PMID 42484581
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PubMedCell reports2026-07-21

Proinflammatory signaling in Ewing sarcoma is driven by retroelement activity and counteracted by reverse transcriptase inhibitors.

Evdokimova Valentina V, Ruzanov Peter P, Gassmann Hendrik H, Hung Minsheng M et al.

Ewing sarcoma (EwS) is a childhood malignancy driven by oncogenic fusion proteins, most commonly EWS::FLI1, and is characterized by paradoxical co-occurrence of inflammation and immunosuppression. Our study shows that LINE, SINE, and LTR/HERV endogenous retroviral elements (EREs) may drive local and systemic inflammation in EwS, and their expression is linked to EWS::FLI1. EREs are not only highly expressed in EwS tumor cells but also disseminated in extracellular vesicles (EVs), selectively targeting blood monocytes and stromal cells and inducing inflammatory responses and immunosuppressive phenotypes. We also demonstrate that some EREs, particularly LINE-1 and HERV-K, retain the ability to encode proteins and to reverse transcribe, coincident with the activation of cGAS-IFN-I, STAT3, and NF-κB antiviral and proinflammatory programs in tumor cells and target monocytes. Treatment with reverse transcriptase (RT) inhibitors abacavir (ABC) and lamivudine (3TC) reduced RT activity, inflammatory signaling, and cytokine release, suggesting a potential strategy for overcoming systemic inflammation and immunosuppression in EwS.

PMID 42479486
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PubMedEuropean journal of obstetrics, gynecology, and reproductive biology2026-07-18

Belgian guidance 2026 on management of pregnancy and breastfeeding in women living with HIV and their infants.

Konopnicki Deborah D, Hainaut Marc M, Adler Catherine C, De Greef Julien J et al.

In 2021, a call was made to write a guidance for the management of pregnancy in women living with HIV (WLWH) in Belgium. The call was sent to BREACH (Belgium Research on AIDS and HIV Consortium), a network of Belgian HIV Reference Centers, Laboratories and interest organizations in the field of HIV. The first working group (30 healthcare workers from 13 institutions) reviewed literature and had online discussions. This Guidance is an expert consensus document designed to answer real life clinical situations; it was presented at BREACH symposium in November 2023 and then updated annually. Antiretroviral drugs prescribed to women considering pregnancy or during pregnancy are classified as 'recommended', 'not recommended', or 'insufficient data. If viral load (VL) at week 36 of pregnancy is ≤50 copies/ml, vaginal delivery without intrapartum zidovudine (IPZ) is recommended but if ≥1000 copies/ml, a scheduled caesarean section (SCS) and IPZ are indicated. In case of VL between 50 and 1000 copies/ml at week 36, IPZ should be given. If maternal VL is ≤50 copies/ml before and throughout pregnancy, antiretroviral prophylaxis for the newborn is not indicated. Benefits and potential risk of breastfeeding should be discussed with the future mother: fully suppressed maternal VL from conception to delivery is considered at very low risk of HIV transmission during breastfeeding. Maternal VL control every 6 weeks and close follow-up by a multidisciplinary team should be offered during exclusive breastfeeding of maximum 6 months to minimize risk of HIV transmission. Shared decision making with the future mother is advised for antiretroviral treatment preference, SCS if VL is between 50 and 1000 copies/ml and infant feeding choices. The Belgian Guidance on management of pregnancy and breastfeeding in WLWH and their infant can be used as a reference for Belgian clinicians and is freely available online.

PMID 42468119
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PubMedAntimicrobial agents and chemotherapy2026-07-17

Population pharmacokinetics of ritonavir-boosted atazanavir in subsequent-line treatment in African children with HIV.

van Dyk Jennie J, Waitt Catriona C, Mugerwa Henry H, Wiesner Lubbe L et al.

Ritonavir-boosted atazanavir (atazanavir/r) is an effective once-daily option for pediatric subsequent-line antiretroviral therapy when used with two nucleoside reverse transcriptase inhibitors (NRTIs). Tuberculosis co-treatment complicates its use because rifampicin markedly induces atazanavir/r clearance. Although twice-daily atazanavir/r can overcome this interaction in adults, data in children are lacking. We aimed to characterize atazanavir population pharmacokinetics in children with HIV and simulate the effect of rifampicin co-treatment. Atazanavir concentration-time data in African children with HIV from CHAPAS-4 (ISRCTN22964075) and VirTUAL (NCT03923231) were analyzed by nonlinear mixed-effect modeling. We investigated the effect of weight, age, atazanavir formulation, ritonavir dose, and NRTI backbone (tenofovir alafenamide [TAF]-emtricitabine, abacavir-lamivudine, or zidovudine-lamivudine). Simulations were performed across weight bands to evaluate atazanavir/r exposures under standard conditions and, using adult-derived induction effects, predict exposures and possible dosing regimens during rifampicin co-treatment. Seventy children were included, with a median (range) age of 10.9 (3.2-17.7) years and weight of 29 (15-85) kg. A two-compartment model with sequential zero- and first-order absorption best described atazanavir disposition. The estimated typical value of atazanavir clearance was 4.8 L/h for a 27-kg individual. Atazanavir pharmacokinetics in children were unaffected by the NRTI backbone. Once-daily atazanavir/r with current dosing guidelines achieved adequate exposures across weight bands. When simulating pharmacokinetics during rifampicin co-treatment, twice-daily atazanavir/r is expected to restore exposures to levels comparable to once-daily dosing without rifampicin. These findings provide a framework for future clinical evaluation in children with HIV and tuberculosis.

PMID 42467063
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PubMedThe Journal of antimicrobial chemotherapy2026-07-15

Virological failure and resistance emergence during treatment with bictegravir/emtricitabine/tenofovir alafenamide or dolutegravir/lamivudine in people living with HIV without prior resistance mutations: a real-world study.

Drumel Thomas T, Kimmerlin Julie J, Allavena Clotilde C, Deschanvres Colin C et al.

To evaluate, in a large real-world cohort of people living with HIV (PLWH) treated with bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) or dolutegravir/lamivudine, rates of virological failure (VF) and resistance emergence. All PLWH receiving BIC/FTC/TAF or dolutegravir/lamivudine without prior NRTI or integrase strand transfer inhibitor (InSTI) resistance-associated mutations (RAMs) and with at least 6 month follow-up between January 2018 and January 2025 were included in this retrospective single-centre study. Demographic, therapeutic and immunovirological data were collected from electronic medical records. VF was defined as confirmed HIV RNA >50 copies/mL or a single HIV RNA >200 copies/mL followed by modification of treatment. Blip was defined as a single HIV RNA between 50 and 200 copies/mL. These thresholds were applied after >6 months of first-line therapy (FLT), or at any timepoint in virological suppression maintenance therapy (MT). Plasma HIV genotyping by Sanger sequencing was performed at the clinician's request, and resistance was interpreted using the ANRS algorithm V35. A total of 1059 PLWH were included: 594 receiving BIC/FTC/TAF (141 FLT and 453 MT) and 465 receiving dolutegravir/lamivudine (23 FLT and 442 MT). VF occurred in 79/1059 PLWH (7.5% overall; 9.8% in the BIC/FTC/TAF group and 4.5% in the dolutegravir/lamivudine group) and blips in 96/1059 PLWH (9.0% overall; 9.9% and 5.8%, respectively, groupwise). Resistance emergence was documented in nine cases (0.9%), four for BIC/FTC/TAF (InSTI-RAM in 1/4) and five for dolutegravir/lamivudine (InSTI-RAM in 3/5). In this real-world cohort, InSTI resistance emergence in PLWH failing BIC/FTC/TAF or dolutegravir/lamivudine was rare at 0.17% and 0.65%, respectively, supporting the robustness of these InSTI-based regimens.

PMID 42455039
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