bictegravir
Biktarvy combines bictegravir with emtricitabine and tenofovir alafenamide into a single daily tablet from Gilead for HIV-1 infection. Bictegravir blocks the viral integrase enzyme, stopping HIV from inserting its genetic material into infected cells.
This page is based on the EMA medicine record and Health Canada product information for Biktarvy, cross-checked with MedlinePlus; the mechanism is explained in plain language, and analogies are used only where they stay accurate.
How it works
Explains what the medicine does in the body, not dosing, side effects, or safety.
An analogy
HIV is like a burglar who breaks into a house and then tries to hide his plans inside the family photo album so copies are made forever. Integrase is the glue that sticks those plans into the album. Bictegravir dries out the glue, so the plans never get filed and the burglar's scheme stops there.
In simple terms
To multiply, HIV must insert its genetic code into the DNA of the immune cells it infects. An enzyme called integrase performs that insertion. Bictegravir binds integrase and blocks its strand transfer step, so the viral DNA stays loose and cannot be copied. Combined with two medicines that block another viral enzyme, the regimen keeps the virus suppressed to undetectable levels.
In depth
Bictegravir is a second-generation integrase strand transfer inhibitor (INSTI) with a bicyclic pyridone carboxylic acid scaffold. It chelates the two-metal centre of HIV integrase and blocks the strand transfer step of proviral integration, with a high barrier to resistance and activity against many first-generation INSTI-resistant variants. In Biktarvy it is coformulated with emtricitabine and tenofovir alafenamide, providing a complete three-drug regimen with once-daily dosing.
See it in motion
A schematic animation of the mechanism — simplified for clarity, not drawn to scale.
How bictegravir, a second-generation INSTI, blocks HIV integrase
- To multiply, HIV must insert its genetic code into the DNA of the immune cells it infects.
- Bictegravir is a second-generation integrase strand transfer inhibitor (INSTI) with a bicyclic pyridone carboxylic acid scaffold.
- It chelates the two-metal centre of HIV integrase and blocks the strand transfer step of proviral integration, with a high barrier to resistance and activity against many first-generation INSTI-resistant variants.
- In Biktarvy it is coformulated with emtricitabine and tenofovir alafenamide, providing a complete three-drug regimen with once-daily dosing.
Target: HIV integrase
A viral enzyme that splices HIV's genetic material into the DNA of the infected human cell, a step the virus cannot complete without; blocking it halts viral replication.
Approved uses
Approved uses differ by country and change over time. Always follow your local prescribing information.
Approved uses in European Union
EMA- Treatment of HIV-1 infection in adults and children from 2 years of age weighing at least 14 kg, without present or past evidence of viral resistance to the integrase inhibitor class, emtricitabine or tenofovir
Official sources
The statements on this page trace back to these records.
- MedlinePlus: bictegravir, emtricitabine, and tenofovir alafenamide
MedlinePlus, U.S. National Library of Medicine
This page explains how the medicine works — it isn’t the patient leaflet. For anything that applies to you, read the leaflet that came with your medicine or ask your pharmacist.
MedUnfold provides educational content and is not medical advice. Always follow your local prescribing information and healthcare professional.