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Islatravir + doravirine + lamivudine is an investigational oral antiretroviral combination for the treatment of HIV-1 infection. - **Islatravir** is a first-in-class nucleoside reverse transcriptase translocation inhibitor (NRTTI) that blocks HIV-1 reverse transcriptase via multiple mechanisms, including acting as a defective DNA building block and inhibiting RT translocation[2][5]. - **Doravirine** is a next-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) approved for HIV-1; it inhibits HIV-1 reverse transcriptase by binding to an allosteric site distinct from the substrate binding site[2][5]. - **Lamivudine** is a nucleoside reverse transcriptase inhibitor (NRTI) that acts as a competitive inhibitor of HIV-1 reverse transcriptase by causing DNA chain termination during viral replication. This combination is typically used for initial treatment, with lamivudine discontinued after 24 weeks if adequate virologic suppression is achieved, transitioning to a two-drug regimen (islatravir + doravirine). Merck has led development, with clinical trials supporting efficacy and safety at multiple dosages[1][2][6].
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