Introduction

Researchers recently investigated Biktarvy insulin sensitivity to clarify its metabolic effects. Biktarvy remains a highly effective single-tablet regimen for achieving viral suppression in people living with HIV. However, some clinical observations have suggested that patients switching to this regimen might experience changes in glycemic control. Consequently, experts sought to quantify these effects using the hyper-insulinaemic-euglycaemic clamp method. This technique is the clinical gold standard for measuring insulin resistance.

Investigating Biktarvy Insulin Sensitivity in Clinical Trials

The study utilized a 72-day crossover design involving healthy volunteers. This specific methodology allowed researchers to isolate the drug's metabolic impact without the confounding influence of HIV-related inflammation. Participants were randomized into two groups to receive either 28 days of Biktarvy or no treatment. Furthermore, the researchers measured the glucose disposal rate (GDR) at multiple intervals. They conducted these assessments at days 1, 28, and 72 to ensure comprehensive data collection.

Results indicated no statistically significant difference in insulin sensitivity after 28 days of treatment. Specifically, the mean GDR values remained stable across both groups throughout the study periods. For instance, Group 1 showed a mean GDR of 7.52 mg/kg/min at baseline compared to 8.50 mg/kg/min at Day 28. Similarly, Group 2 exhibited consistent results between their treatment and non-treatment phases. Therefore, short-term administration of Biktarvy does not appear to impair glucose disposal in healthy individuals.

Clinical Implications for HIV Management

These findings provide reassurance regarding the acute metabolic safety of this antiretroviral regimen. Nevertheless, the authors emphasized the necessity for long-term data. While 28 days of exposure showed neutral results, real-world evidence often tracks metabolic changes over several years. Clinicians should continue monitoring fasting glucose and lipid profiles in patients on long-term therapy. Additionally, lifestyle interventions remain vital for managing metabolic health in the aging HIV population. Future research should investigate if similar neutral effects occur in individuals with pre-existing metabolic comorbidities.

Frequently Asked Questions

Does Biktarvy cause insulin resistance?

Based on a recent 28-day study in healthy volunteers, Biktarvy did not significantly impact insulin sensitivity or glucose disposal rates. The researchers found that metabolic profiles remained stable during the treatment phase.

How was insulin sensitivity measured in this study?

Researchers used the hyper-insulinaemic-euglycaemic clamp method. This procedure provides the most accurate assessment of how the body handles glucose under controlled insulin levels, making it more reliable than simple fasting glucose tests.

Disclaimer: This content is for informational and educational purposes only... Refer to the latest local and national guidelines for clinical practice.

References

Heskin J et al. The effect of Biktarvy (B/F/TAF) on whole-body insulin sensitivity, lipid and endocrine profile in healthy volunteers. HIV Med. 2026 Feb 18. doi: 10.1111/hiv.70208. PMID: 41709099.

Busca-Arenzana C et al. Metabolic effects of switching to Biktarvy (B/F/TAF) in patients with HIV-1: The Metabic study. HIV Med. 2024;25(9):1030-1039.

Gilead Medical Information. Biktarvy (BIC/FTC/TAF) Effect on Glucose or Insulin. Updated Jan 2026.