Tenofovir Alafenamide — Just Different or Better?

Tenofovir disoproxil fumarate (TDF) is a component of most recommended initial antiretroviral therapy (ART) regimens in the DHHS HIV Treatment Guidelines. Although generally well tolerated, it is associated with greater reductions in bone-mineral density than other reverse transcriptase inhibitors and occasionally causes significant renal toxicity. Both of these adverse events are related to tenofovir plasma levels. Another tenofovir prodrug, tenofovir alafenamide (TAF), delivers high intracellular tenofovir concentrations with 90% lower plasma drug concentrations, suggesting that it may have less toxicity than TDF. Now, researchers have conducted two manufacturer-sponsored, double-blind, multinational clinical trials to explore this issue.…