Long-term effectiveness of bictegravir/emtricitabine/tenofovir alafenamide in people with HIV and resistance-associated mutations.

Resistance-associated mutations (RAMs) limit treatment options for HIV. We evaluated virologic outcomes in people with HIV harboring RAMs who switched to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in a real-world cohort during 4 years of follow-up. Virologic suppression was sustained across RAM subgroups, including M184V/I with additional nucleoside reverse transcriptase inhibitor (NRTI)-RAMs. Stratification by genotypic susceptibility score (GSS) suggests robust effectiveness. B/F/TAF demonstrates durable long-term suppression in different resistance profiles, supporting its use in this population.