News|Articles|February 24, 2026

Switch to Dovato Linked to Lower Rates of Steatotic Liver Disease vs Biktarvy at 96 Weeks

Fact checked by: Justin Mancini

New 96-week subgroup data from the PASO-DOBLE study show that adults with virologically suppressed HIV who switched to dolutegravir/lamivudine experienced significantly lower rates of steatotic liver disease than those who switched to bictegravir/emtricitabine/tenofovir alafenamide, particularly among individuals with clinically meaningful weight gain.

ViiV Healthcare announced 96-week results from a planned subgroup analysis of the PASO-DOBLE (GeSIDA 11720) study. The data were presented at the Conference on Retroviruses and Opportunistic Infections in Denver, Colorado.

The analysis found that switching to dolutegravir/lamivudine (DTG/3TC; Dovato) was associated with a lower proportion of steatotic liver disease (SLD) compared with switching to bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy; BIC/FTC/TAF) in adults living with HIV who had virological suppression.

PASO-DOBLE is the largest head-to-head phase 4 randomized clinical trial comparing the 2-drug regimen DTG/3TC with the 3-drug regimen BIC/FTC/TAF in this population. The 96-week substudy focused on SLD, an increasingly recognized comorbidity linked to metabolic health and weight gain in people living with HIV.

“This 96-week PASO-DOBLE subanalysis adds to the robust clinical and real-world data for Dovato, showing differences between the 2-drug regimen DTG/3TC and BIC/FTC/TAF as a 3-drug regimen in metabolic health outcomes,” ViiV Healthcare Chief Medical Officer Jean van Wyk, MBChB, MFPM, said in a statement. “These findings allow health care providers and people living with HIV to make informed choices regarding long-term HIV treatment, including considerations around impact on metabolic health.”

Learn more about the PASO-DOBLE study with insights from van Wyk.

What You Need to Know

Switching to DTG/3TC was associated with significantly lower rates of steatotic liver disease than switching to BIC/FTC/TAF at 96 weeks.

The difference in SLD was most pronounced in participants who gained 5% or more of baseline body weight, highlighting the link between metabolic changes and liver health.

Alongside maintained virologic suppression and less weight gain, the findings add to evidence supporting DTG/3TC as a long-term treatment option with potential metabolic health advantages.

The substudy included 111 adults who switched treatment: 58 to DTG/3TC and 53 to BIC/FTC/TAF. At week 96, SLD was observed in 49% of participants receiving BIC/FTC/TAF compared with 29% of those on DTG/3TC (P = .033). Differences were most pronounced among individuals with clinically meaningful weight gain (≥ 5% of baseline body weight), where SLD occurred in 76% of participants on BIC/FTC/TAF vs 17% on DTG/3TC (P = .002). No significant differences were seen in participants with less than 5% weight gain, and the treatment regimen remained independently associated with SLD after adjustment for baseline factors.

These findings build on previously reported 96-week PASO-DOBLE results showing less weight gain with DTG/3TC compared with BIC/FTC/TAF while maintaining noninferior virologic suppression. Given the close relationship between weight gain, metabolic changes, and liver steatosis, the new data provide further insight into long-term metabolic and hepatic outcomes following treatment switches.

Reference
ViiV Healthcare announces data showing switching to Dovato was associated with a lower proportion of steatotic liver disease versus Biktarvy for HIV-1 treatment. Press release. ViiV Healthcare. February 23, 2026. Accessed February 24, 2026.
https://viivhealthcare.com/hiv-news-and-media/news/press-releases/2026/february/steatotic-liver-disease-versus-biktarvy/


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