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First-line ART regimens for adults by ART preference Preferred Scheme Alternative schemes Special cases TDF** + 3TC** + EFV** [37,109,110,111,112] TDF** + FTC + EFV** [37,109,110,111,112,131,132] TDF** + 3TC** + DTG** [37,133,134,135] TDF** + FTC + DTG** [37,133,134,135] TDF** + 3TC +ESV** [136, 137, 138] TDF** + FTC + ESV**[136, 137, 138] ABC** + 3TC** + DTG** [37,139] TDF** + 3TC** + EFV**400 [37,135,140,141] schemes that include TDF**, ABC**, ZDV**, F-AZT**, 3TC**, FTC, [5,9,10,11,37] ritonavir-boosted protease inhibitors (ATV** ATV**+r**, LPV/r**, DRV**+r**), RAL** RPV/TDF/FTC**, ETR**, [5,9,10,11,37] EVG/C/FTC/TAF (listed for Vital and Essential Drugs for 2021) [37,133,142,143] BIC/FTC/TAF, DOR [37,133,142,143] recommended to preferentially use ARVP as part of fixed dose combinations (FDC) to improve adherence to therapy, ease of use [127] (2A) recommended that physicians responsible for the care of HIV-infected patients use their preferred ART regimens when starting first-line ART (starting ART): tenofovir** in combination with lamivudine** plus efavirenz** [37,109,110,111,112] (2A) tenofovir** in combination with emtricitabine plus efavirenz** [37,109,110,111,112,131,132] (2A) tenofovir** plus lamivudine** plus dolutegravir** [37,133,134,135] (3B) tenofovir** plus emtricitabine plus dolutegravir** [37,133,134,135] (1A) tenofovir** plus lamivudine** plus elsulfavirine** [ 136, 137, 138] (4C) tenofovir** plus emtricitabine plus elsulfavirin** [136, 137, 138] (4C) Comments: Preferred regimens may also be given to patients with active TB (when prescribing dolutegravir** in patients with TB who are on rifampicin**, a dose increase of dolutegravir** at a dose of 50 mg twice daily is required when use with rifampicin**) and chronic hepatitis B; recommended that physicians responsible for monitoring HIV-infected patients use TDF ** with caution in patients with renal insufficiency: if creatinine clearance decreases to 30-49 ml / min, a dose adjustment is necessary; with a decrease in creatinine clearance below 30 ml / min, it is possible to prescribe TDF ** only if there are no alternatives, see table. recommended for physicians responsible for the care of HIV-infected patients due to its better tolerability compared to EFV** 600 mg, less risk of treatment discontinuation due to side effects with comparable efficacy in suppressing VL.