Latest research on Tenofovir

Tenofovir disoproxil fumarate (a prodrug of tenofovir), marketed by Gilead Sciences under the trade name Viread®, belongs to a class of antiretroviral drugs known as nucleotide analogue reverse transcriptase inhibitors (nRTIs), which block reverse transcriptase, an enzyme crucial to viral production in HIV-infected people. [Wikipedia] In vivo tenofovir disoproxil fumarate is converted to tenofovir, an acyclic nucleoside phosphonate (nucleotide) analog of adenosine 5'-monophosphate.

Tenofovir side effects

Results from randomized trials and cohort studies have shown an increased risk of renal adverse events when TDF is used in combination with a ritonavir-boosted PI and when Tenofovir plasma concentrations are high [40–43]. [source, 2016]
Patients receiving TAF were more likely to show increases in LDL cholesterol and total cholesterol plasma levels, as Tenofovir tends to lower lipid levels. [source, 2016]
While adherence <95% increased the risk of virologic failure (aHR, 1.28; 95% CI, 1.07–1.54), the inclusion of adherence in the Cox model had no notable effect on the HR or CI of the remaining covariates (Tenofovir group aHR, 1.48; 95% CI, 1.21–1.80). [source, 2016]
The effect of regimen on time to virologic failure was consistent between the primary and time-updated models and reflected a 47% increase in the risk of virologic failure for patients in the Tenofovir group (aHR, 1.47; 95% CI, 1.24–1.75). [source, 2016]
Notably, we did not observe significantly higher virologic failure in the Tenofovir group after 12 months of ART, suggesting that patients already virologically suppressed on Nevirapine plus Tenofovir may not be at increased risk for virologic failure. [source, 2016]
Given access to all available drugs, more than three-quarters of doctors would use the WHO recommended first line fixed dose combination of Tenofovir (TDF), Emtricitabine (or the equivalent analogue, Lamivudine) and Efavirenz (EFV) for themselves, suggesting high confidence in the efficacy and side effect profile of the combination. [source, 2016]
The mechanism by which Tenofovir may cause renal damage is not well understood, although interference with transporter proteins in the renal tubule may play a role. [source, 2016]
Because Cidofovir, adefovir, and Tenofovir are all nucleotide analogues, Tenofovir accumulation within tubular epithelial cells also may interfere with renal function. [source, 2016]
A recent report by Calcagno et al. showed that the CC genotype of the ABCC4 4976 was associated with markedly decreased urinary exclusion of Tenofovir, although plasma concentration of Tenofovir did not differ between different genotypes at ABCC4 4976 [29]. [source, 2016]
Nineteen patients were on Tenofovir disoproxil fumarate (a first-line drug for the treatment of chronic hepatitis B),29 which is also reported to cause lactic acidosis. [source, 2015]