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Tenofovir alafenamide revisited
1Infectious Diseases Unit, Department of Medical Sciences, University of Torino, Amedeo di Savoia Hospital, Torino, Italy.
Le Infezioni in Medicina
|December 1, 2020
Summary
Tenofovir Alafenamide (TAF) offers comparable HIV/HBV treatment to Tenofovir Disoproxil Fumarate (TDF) with fewer bone and kidney side effects. TAF is preferred, especially for aging patients, due to TDF
Area of Science:
- Pharmacology and Virology
- Drug Safety and Efficacy
Background:
- Two tenofovir prodrugs, TAF and TDF, treat HIV and HBV.
- TDF is linked to renal tubule dysfunction and decreased bone mineral density (BMD).
- TAF was developed as a safer alternative to TDF.
Purpose of the Study:
- To compare the safety and efficacy of TAF and TDF.
- To evaluate the impact of TAF versus TDF on renal and bone health.
- To discuss the cardiovascular risk associated with TDF and TAF treatment.
Main Methods:
- Pharmacological property comparison of TAF and TDF.
- Analysis of clinical data regarding renal function and BMD.
- Consideration of cardiovascular risk factors associated with each drug.
Main Results:
- TAF delivers more active drug to target cells with less systemic circulation compared to TDF.
- TAF demonstrates comparable antiretroviral action to TDF with significantly lower impact on renal tubules and bone integrity.
- TDF has lipid-lowering effects and is less associated with weight gain, but TAF shows a better safety profile for kidneys and bones.
Conclusions:
- TAF is a safer alternative to TDF, particularly for aging patients, due to reduced renal and bone toxicity.
- While TDF has some metabolic benefits, the potential for irreversible kidney and bone damage necessitates caution.
- Avoiding TDF is preferable, especially in aging populations, to mitigate long-term health risks.
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