Lamivudine

Lamivudine has remained a cornerstone of HIV therapy for over two decades. This review highlights its pharmacologic and virologic propertie, potent reverse transcriptase inhibition without human polymerase toxicity, that have enabled its continued use in modern combination regimens. Beyond traditional triple-drug therapy, lamivudine is now incorporated into single-tablet regimens to improve adherence and into emerging two-drug regimens designed to reduce long-term cumulative drug exposure. Its versatility and favorable safety profile make it indispensable in both resource-rich and resource-limited settings.

Fig. 1 Proportion of patients in individual studies who achieved viral load <50 copies per milliliter after 48 or 52 weeks on therapy. (Quercia R, et al., 2018)

In a double‑blind trial of 24 patients with center‑involved diabetic macular edema, oral lamivudine (150 mg twice daily) improved best‑corrected visual acuity by 9.8 letters at 4 weeks (vs. a 1.8‑letter decrease with placebo; P<0.001). At 8 weeks, lamivudine plus bevacizumab improved BCVA by 16.9 letters vs. 5.3 with placebo+bevacizumab. Lamivudine, an oral inflammasome inhibitor, significantly improves vision in DME and may be a low‑cost alternative to anti‑VEGF injections.

Fig. 2 Change in Visual Acuity. (Pereira F, et al., 2025)