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Is Biktarvy a protease inhibitor?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Aug 9, 2021.

Official answer

by Drugs.com

No, Biktarvy is not a protease inhibitor. It is a combination integrase inhibitor and reverse transcriptase inhibitor used in the treatment of people living with HIV.

  • Biktarvy contains three antiretroviral medicines, bictegravir, emtricitabine, and tenofovir alafenamide. You may see the name Biktarvy abbreviated BIC / FTC / TAF.
  • Bictegravir is classified as an integrase strand transfer inhibitor (INSTI), or sometimes just called an integrase inhibitor.
  • Emtricitabine / tenofovir alafenamide is classified as a nucleoside/nucleotide reverse transcriptase inhibitor (NRTI).

In studies looking at Biktary for HIV treatment, most patients were able to reach an undetectable level of virus in their blood with Biktarvy (fewer than 50 copies of HIV per milliliter of blood).

How does Biktarvy work?

The HIV virus uses three different enzymes to convert RNA, the genetic material that allows the virus to multiply, into DNA. The three enzymes that are targeted by HIV antiretroviral medicines include reverse transcriptase, integrase, and protease. Biktarvy specifically blocks (inhibits) integrase and reverse transcriptase.

Integrase inhibitors like bictegravir work by blocking integrase, an enzyme needed for HIV replication.

  • HIV uses integrase to insert its viral DNA into the human CD4 cell (a T cell, or white blood cell). CD4 cells are important to help fight infections, but their numbers decrease in patients with HIV.
  • HIV cannot make copies (replicate) when integrase is blocked by an integrase inhibitor.

Nucleoside / nucleotide reverse transcriptase inhibitors (NRTIs) like emtricitabine / tenofovir alafenamide work by blocking reverse transcriptase, an enzyme needed for HIV replication.

  • HIV uses reverse transcriptase to convert RNA into DNA in the CD4 cell.
  • When reverse transcriptase is blocked by the NRTI medicine, the virus cannot make copies of itself because it does not have the DNA to do it.

Biktarvy is used to treat (not prevent) HIV infection in at-risk people and is not used as pre-exposure prophylaxis (PrEP). Descovy (emtricitabine / tenofovir alafenamide fumarate) and Truvada (emtricitabine / tenofovir disoproxil fumarate) are the FDA-approved medications used for PrEP.

Related information: HIV Treatment Options: An Overview

This is not all the information you need to know about Biktarvy for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full Biktarvy information here, and discuss this information and any questions you have with your doctor or other health care provider.

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