References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Biktarvy is a single-tablet once-daily HIV treatment that combines three medicines: bictegravir, emtricitabine and tenofovir alafenamide (TAF). It’s one of the most widely used first-line HIV treatments in the UK because it’s effective, well tolerated and has relatively few drug interactions.
Here’s what you need to know about how Biktarvy works, what to expect and how it fits into modern HIV care.
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What’s in Biktarvy?
| Ingredient | Class | Role |
|---|---|---|
| Bictegravir 50mg | Integrase strand transfer inhibitor (INSTI) | Stops HIV integrating into CD4 cell DNA |
| Emtricitabine 200mg | NRTI | Blocks HIV reverse transcription |
| Tenofovir alafenamide 25mg | NRTI | Blocks HIV reverse transcription |
Biktarvy is a complete HIV regimen — you don’t need any other HIV medication alongside it.
Who Can Take It?
Biktarvy is suitable for most adults and adolescents weighing at least 25kg who are starting HIV treatment for the first time, or switching from another effective regimen with an undetectable viral load. It has no restriction based on viral load at the start of treatment, unlike some older drugs.
How to Take Biktarvy
Take one tablet once a day, with or without food. Try to take it at the same time each day to build a consistent routine. Missing doses occasionally is fine, but regularly missed doses can allow HIV to replicate and develop resistance.
Side Effects
Biktarvy is generally well tolerated. Possible side effects include:
- Headache (usually mild, settles)
- Nausea
- Diarrhoea
- Tiredness
- Sleep disturbance or vivid dreams in a minority
- Mood changes in a small number of people
- Weight gain (more common with modern INSTI-based regimens)
Kidney and bone effects are less pronounced with tenofovir alafenamide than with the older tenofovir disoproxil form.
Drug Interactions to Watch
- Antacids and mineral supplements (calcium, iron, magnesium) — take Biktarvy 2 hours before or 6 hours after
- Rifampicin and rifabutin — not recommended with Biktarvy
- Some anticonvulsants — discuss with your HIV team
- St John’s Wort — can lower Biktarvy levels
Monitoring on Biktarvy
You’ll have regular HIV clinic visits with blood tests for viral load, CD4 count, kidney and liver function, and weight. Your clinic will also check for general health markers like cholesterol and blood pressure.
Read more: What is HIV? | HIV and the immune system | Dovato for HIV
Frequently Asked Questions
Is Biktarvy a first-line treatment?
Yes. UK and international guidelines recommend Biktarvy as a first-line option for most people starting HIV treatment.
Do I need food with Biktarvy?
No. Biktarvy can be taken with or without food, which makes it convenient compared to some older single-tablet regimens.
Will Biktarvy make me gain weight?
Some people gain weight on modern INSTI-based regimens including Biktarvy. The reason isn’t fully understood and may involve the drugs, the improved health after starting treatment, and individual factors.
Related reading
- Choosing the Right PrEP Drug: Truvada vs Descovy
- Dovato for HIV: A Two-Drug Regimen
- Triumeq for HIV: A Straightforward Guide
- Efavirenz for HIV: An Older NNRTI Still in Use
- Eviplera: How This Anti-HIV Drug Works
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
