Tenofovirbased

Tenofovir-based regimens refer to antiretroviral therapies and PrEP strategies that include tenofovir as the active antiviral agent. Tenofovir is available in two prodrug forms: tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF). These regimens are used to treat HIV infection and to protect against HIV acquisition in people at risk (pre-exposure prophylaxis, PrEP). Tenofovir also treats hepatitis B virus (HBV) in chronic infection.

TDF delivers higher systemic exposure than TAF, which can raise the risk of kidney injury and bone mineral density loss with long-term use. TAF achieves similar antiviral activity with lower plasma exposure, improving renal and bone safety while maintaining efficacy. Safety monitoring often includes kidney function and bone health assessments.

In HIV treatment, tenofovir is commonly paired with emtricitabine as a backbone and combined with a third agent such as an integrase inhibitor, an NNRTI, or a boosted protease inhibitor, in single-tablet regimens. Examples include TDF/FTC with efavirenz (historic fixed-dose combinations such as Atripla), TDF/FTC with elvitegravir/cobicistat (Stribild) and TAF-based regimens such as TAF/FTC/elvitegravir/cobicistat (Genvoya) or bictegravir/emtricitabine/TAF (Biktarvy). For PrEP, TDF/FTC (Truvada) has been standard, while TAF/FTC (Descovy) is approved for PrEP in select populations and routes of exposure.

Tenofovir is also active against HBV and is used in HBV treatment regimens, sometimes in combination with other drugs. Because of potential renal and bone effects, renal function monitoring and dose adjustments may be required in people with kidney impairment.