MR and YSP are employees of ViiV Healthcare. (virologic suppression [VS], CD4+ cell count change from baseline) and security (adverse events [AEs], discontinuations, discontinuation due to AEs, lipid changes) were analyzed at Week 48 using Bayesian NMA methodology, which allowed calculation of probabilistic results. Subgroup analyses were conducted for VS (baseline viral weight [VL] / ?100,000copies/mL, / ?500,000copies/mL; baseline CD4+ / 200cells/L). Results were adjusted for the nucleoside/nucleotide reverse transcriptase inhibitors (NRTI) combined with the core agent (except subgroup analyses). Results The NMA included 36 studies; 2 additional studies were included in subgroup analyses only. Odds of achieving VS with DTG were statistically superior to PIs (odds ratios [ORs] 1.78C2.59) and NNRTIs (ORs 1.51C1.86), and similar but numerically higher than other INSTIs. CD4+ count increase was significantly greater with DTG than PIs (difference: 23.63C31.47 cells/L) and efavirenz (difference: 34.54 cells/L), and much like other core agents. INSTIs were more likely to result in patients achieving VS versus PIs (probability: 76C100%) and NNRTIs (probability: 50C100%), and a greater CD4+ PNU-103017 count increase versus PIs (probability: 72C100%) and NNRTIs (probability: 60C100%). DTG was more likely to result in patients achieving VS (probability: 94C100%), and a greater CD4+ count increase (probability: 53C100%) PNU-103017 versus other core brokers, including INSTIs (probability: 94C97% and 53C93%, respectively). Security outcomes with DTG were PNU-103017 generally much like other core brokers. In patients with baseline PNU-103017 VL? ?100,000copies/mL or??200 CD4+cells/L (18 studies), odds of achieving VS with DTG PNU-103017 were superior or much like other core brokers. Conclusion INSTI core brokers experienced superior efficacy and comparable security to PIs and NNRTIs at Week 48 in treatment-na?ve patients with HIV-1, with DTG being among the most efficacious, including in patients with baseline VL? ?100,000copies/mL or??200 CD4+cells/L, who can be difficult to treat. Electronic supplementary material The online version of this article (10.1186/s12879-019-3975-6) contains supplementary material, which is available to authorized users. The NMA methods used here were generally consistent with those of previous studies [11, 12], with the addition of probabilistic results to rank therapies. Unlike previous NMAs, which did not include data for the NRTI TAF as it was not recommended at the time, this NMA included grouped data on TDF or TAF in combination with core brokers. The grouping of TDF and TAF could be perceived as a limitation of this analysis, due to the possibility of these NRTIs having different effects independent of the core agent. However, data from head-to-head studies in which TAF and TDF (both with EVG/c and FTC) were compared hN-CoR in treatment-na?ve patients with HIV-1 support this approach, as TAF was shown to be non-inferior to TDF in terms of VS, with comparable safety profiles . No previous NMA has included BIC, as they were undertaken before its approval in 2018 [11, 12]. The US DHHS and EACS now recommend the INSTIs BIC in addition to DTG and RAL as favored first-line core brokers for treatment-na?ve adults, while the WHO does not recommend BIC or RAL, recommending a DTG-based regimen [7, 8, 10]. The current analyses included all recently published studies evaluating core brokers for treatment-na?ve patients with HIV, including BIC, and allowed them to be ranked based on their ability to achieve VS relative to DTGOverall, the results of this analysis are in line with those of previous NMAs, with INSTIs having superior efficacy to ritonavir-boosted PIs and NNRTIs in treatment-na?ve patients [11, 12]The 2016 NMA.