Question

Dear Doctor, I heard that:

  1. TAF is lower toxicity compared to TDF, and
  2. Efavirenz on 400mg is as effective as 600mg/day Will the new Atripla will address both of that?, also

My country's Atripla is the generic one, which added with lamivudine instead of emtricitabine. Is it practically the same?

Thank you and stay awesome.

Answer

Hello and thanks for posting.

You're right- TAF has less toxicity than TDF, 400 mg efavirenz causes fewer side effects than 600 mg, and lamivudine (3TC) is essentially the same as emtricitabine.

In low- or middle-income countries where generic versions of Atripla are sold, I'd expect a TDF/3TC/400 mg efavirenz in the near future- this combination has been recommended by the World Health Organization's preview of upcoming guidelines, so I'd expect generic manufacturers to take up the call relatively soon.

As for TAF reaching low- or middle-income countries in generic formulations, we'll have to see. The product is not yet (but very soon) to be available in several co-formulated products in the US and Europe.

Thanks for reading, BY