Single daily pill could replace complex HIV drug regimens for older patients

A new once-daily tablet that combines two existing HIV medicines, bictegravir and lenacapavir (BIC/LEN) could dramatically simplify treatment for people currently taking multiple pills each day.

Results from a phase three clinical trial, led by Professor Chloe Orkin of Queen Mary University of London, were presented at the 2026 Conference on Retroviruses and Opportunistic Infections in Denver and published in The Lancet.

While many people living with HIV now use a single daily pill or long-acting injections, those with drug-resistant virus often remain on complicated multi-tablet regimens. These complex treatments can increase the risk of drug interactions, especially in older adults who are also taking medications for other conditions.

Many of the affected patients were diagnosed early in the HIV epidemic and have been living with the virus for more than 30 years.

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The international trial enrolled more than 550 participants across 15 countries. Most had been taking between two and 11 HIV pills daily, and about 40% required more than one dose per day. Many also had other health conditions, including cardiovascular or kidney disease, and a history of resistance to previous therapies.

Nearly 96 percent of those who switched to the new single-pill regimen maintained viral suppression, with no new resistance detected and no significant safety concerns. Participants who stayed on their existing multi-pill treatments achieved similar viral control rates of about 94–96 percent.