Apr 10, 2006
I have a couple of questions. As I keep reading more and more reports and studies about the positive effects of Viread (also a component of Truvada), I am really curious to know 1) Do you know of any cases of resistance to this drug and 2) If not, could it potentially be a "breakthrough" drug in the fight against HIV? I know that because it is a relatively new drug not all is known about its performance and potential side effects. However, as time passes, the more good things seem to be written about it. I would like your perspective.
Response from Dr. Sherer
Yes, there an many well-documented cases of viruses that are resistant to tenofovir. While it is a very useful drug in many ways, it is not a 'super' drug relative to resistance, and its doubtful that such an anti-HIV drug is achievable.
Resistance to tenofovir occurs with a signature mutation - the K65R -in the presence of multiple TAMS or thymidine mutations, which are result from viremia in the presence of stavudine or zidovudine, and the M184 mutation which is associated with lamivudine resistance.
Also, tenofovir requires dose reduction in the presence of renal disease, and can lead to kidney injury, in particular in patients with pre-existing kidney disease.
Its benefits are that its dosed once daily at the most, with a long serum half life, and its very well tolerated with few short term side effects.
So its a very good drug, but not a super-drug. I suggest that you talk to your doctor about it for further information.
Treatment naive patient
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