Three Key Updates in HIV Treatment: EACS Guidelines

At HIV Drug Therapy Glasgow 2026, three important updates to the European AIDS Clinical Society (EACS) treatment recommendations were highlighted, reflecting a move towards more flexible and individualized HIV care.

1. Dolutegravir/Lamivudine (DTG/3TC)

The previous baseline HIV viral load threshold of 500,000 copies/mL has been removed, potentially expanding eligibility for this two-drug regimen. Other clinical criteria, including resistance and hepatitis B status, remain important.

2. Historical M184V resistance mutation

A previously documented M184V mutation no longer automatically excludes patients from switching to a lamivudine-based two-drug regimen. However, treatment decisions still require careful assessment of resistance history and virological control.

3. Long-acting Cabotegravir/Rilpivirine (CAB/RPV LA)

Injectable treatment may now be considered for selected patients who have not achieved viral suppression, provided strict clinical criteria and close monitoring are in place.

Key takeaway: These developments highlight a shift towards more personalized HIV treatment, potentially expanding therapeutic options for people with complex treatment histories or difficulties maintaining daily oral therapy.