Viread: Uses, Dosage & Side Effects
A nucleotide reverse transcriptase inhibitor (NtRTI) used to treat HIV-1 infection and chronic hepatitis B virus (HBV) infection
Viread (tenofovir disoproxil) is an antiviral medication belonging to the nucleotide reverse transcriptase inhibitor (NtRTI) class. It is used to treat HIV-1 infection in combination with other antiretroviral agents and as monotherapy for chronic hepatitis B virus (HBV) infection. Tenofovir works by blocking the enzymes (reverse transcriptase in HIV and DNA polymerase in HBV) that these viruses need to replicate. Viread is available as film-coated tablets in 245 mg and 123 mg strengths and is taken once daily with food. It is manufactured by Gilead Sciences and is also available as generic versions from multiple manufacturers worldwide.
Quick Facts: Viread
Key Takeaways
- Viread (tenofovir disoproxil) is an antiviral medication used to treat both HIV-1 infection (always in combination with other antiretroviral drugs) and chronic hepatitis B, working by blocking the enzymes these viruses need for replication.
- Kidney function must be monitored before and during treatment because tenofovir can cause kidney damage, including proximal renal tubular dysfunction and, in rare cases, Fanconi syndrome or renal failure.
- Stopping Viread in patients with hepatitis B can trigger severe acute exacerbations of the infection, so treatment should never be discontinued without medical supervision and close follow-up.
- Long-term use of tenofovir disoproxil has been associated with decreased bone mineral density; patients with osteoporosis risk factors or a history of fractures should be monitored accordingly.
- Viread does not cure HIV or hepatitis B, and patients remain infectious even while on treatment; barrier precautions and safe practices must continue to prevent transmission.
What Is Viread and What Is It Used For?
Viread contains the active substance tenofovir disoproxil, which is a prodrug that is rapidly converted in the body to tenofovir, a nucleotide analogue of adenosine monophosphate. Tenofovir is then phosphorylated intracellularly to its active form, tenofovir diphosphate, which exerts its antiviral effect by competing with the natural substrate deoxyadenosine 5'-triphosphate for incorporation into viral DNA. Once incorporated, tenofovir diphosphate causes premature chain termination, effectively halting viral replication.
In HIV-1 infection, tenofovir diphosphate inhibits HIV-1 reverse transcriptase, the enzyme responsible for converting the viral RNA genome into DNA so that it can integrate into the host cell genome. In hepatitis B virus infection, tenofovir diphosphate targets HBV DNA polymerase, the enzyme that replicates the viral DNA. By blocking both of these essential viral enzymes, Viread is effective against two distinct but serious viral infections. For HIV, Viread is classified as a nucleotide reverse transcriptase inhibitor (NtRTI), sometimes grouped broadly with nucleoside reverse transcriptase inhibitors (NRTIs) as they share a similar mechanism of action.
It is critically important to understand that Viread does not cure either HIV or hepatitis B. In HIV-infected patients, the virus persists in cellular reservoirs even when plasma viral load is suppressed to undetectable levels, and treatment must be continued indefinitely. In patients with chronic hepatitis B, tenofovir suppresses viral replication and can lead to improvements in liver histology, including reversal of fibrosis in some patients, but the virus is not eradicated and stopping treatment carries the risk of severe hepatitis flares. Furthermore, patients on Viread can still transmit HIV or HBV to others, and appropriate preventive measures must be maintained.
Approved Indications
Viread is approved by the European Medicines Agency (EMA), the U.S. Food and Drug Administration (FDA), and regulatory authorities worldwide for the following indications:
- HIV-1 infection in adults: Viread 245 mg is used in combination with other antiretroviral medicinal products for the treatment of HIV-1 infection in adults. The choice to use tenofovir disoproxil should be based on resistance testing and/or treatment history. Viread is a cornerstone component of many first-line antiretroviral regimens recommended by WHO, BHIVA, DHHS, and EACS guidelines.
- HIV-1 infection in children and adolescents: Viread is approved for use in pediatric patients aged 6 years and older. The 123 mg tablets are specifically designed for children aged 6 to under 12 years weighing 17 kg to less than 22 kg. In pediatric HIV, Viread is used as part of combination antiretroviral therapy, typically after treatment failure with other regimens due to resistance or intolerance.
- Chronic hepatitis B in adults: Viread 245 mg is used for the treatment of chronic hepatitis B in adults with compensated liver disease, with evidence of active viral replication, persistently elevated serum alanine aminotransferase (ALT) levels, and histological evidence of active inflammation and/or fibrosis. Tenofovir disoproxil is recommended as a first-line treatment for chronic HBV by EASL, AASLD, and WHO guidelines due to its high barrier to resistance.
- Chronic hepatitis B in children: Viread is approved for the treatment of chronic hepatitis B in pediatric patients aged 6 to under 12 years with adequate body weight. The 123 mg tablets are designated for children weighing 17 kg to less than 22 kg.
Patients who are coinfected with both HIV and HBV benefit from Viread because it is active against both viruses simultaneously. In coinfected patients, it is essential to maintain Viread (or another HBV-active agent) even if the antiretroviral regimen is changed for HIV-related reasons, as discontinuing HBV-active therapy can precipitate severe hepatitis flares. International guidelines from WHO and BHIVA recommend that all coinfected patients receive a tenofovir-containing regimen.
What Should You Know Before Taking Viread?
Contraindications
Viread is contraindicated in patients with known hypersensitivity to tenofovir, tenofovir disoproxil, or any of the excipients in the formulation. Allergic reactions, although rare, may manifest as rash, itching, swelling of the face, lips, tongue, or throat, and difficulty breathing. If any signs of hypersensitivity occur, treatment should be stopped immediately and urgent medical attention should be sought.
Warnings and Precautions
Kidney function: Tenofovir disoproxil is primarily eliminated through the kidneys and can cause nephrotoxicity, including proximal renal tubular dysfunction, acute renal failure, and Fanconi syndrome (a condition characterized by the kidney tubules' failure to properly reabsorb substances including phosphate, glucose, amino acids, and bicarbonate). Kidney function should be assessed using serum creatinine, estimated creatinine clearance, and urinary phosphate before initiating therapy and at regular intervals during treatment. Patients with pre-existing renal impairment are at greater risk and may require dose adjustments or alternative medications. Viread should generally not be used in children with renal impairment.
Bone effects: Tenofovir disoproxil has been associated with decreases in bone mineral density (BMD). Clinical studies have shown reductions in BMD at the hip and spine in both adults and children treated with tenofovir-containing regimens. The most pronounced bone loss has been observed when tenofovir disoproxil is used in combination with a boosted protease inhibitor. The long-term consequences for bone health and fracture risk remain uncertain, and patients with risk factors for osteoporosis (including postmenopausal women, the elderly, patients on corticosteroids, and those with a history of pathological fractures) should be monitored with bone densitometry. In children and adolescents, the impact of bone mineral density loss on growth and long-term skeletal health warrants careful consideration.
Lactic acidosis: Lactic acidosis, a rare but potentially fatal complication associated with nucleoside/nucleotide analogue therapy, has been reported with tenofovir disoproxil. Symptoms may include deep, rapid breathing, drowsiness, nausea, vomiting, and abdominal pain. Patients who develop these symptoms should seek immediate medical attention. Risk factors for lactic acidosis include female sex, obesity, and prolonged nucleoside/nucleotide exposure. Hepatomegaly with steatosis (fatty liver) may also accompany lactic acidosis.
Hepatitis B flares on discontinuation: In patients with chronic hepatitis B (with or without HIV coinfection), discontinuation of Viread has been associated with severe acute exacerbations of hepatitis. These flares can be life-threatening, particularly in patients with advanced liver disease or cirrhosis. Liver function should be monitored closely for at least several months after stopping tenofovir therapy, and treatment may need to be reinitiated if clinical or laboratory evidence of hepatitis worsening is observed. The decision to discontinue HBV treatment should always involve a specialist.
Immune reconstitution syndrome: In HIV-infected patients with severe immunodeficiency at the time of initiation of antiretroviral therapy, an inflammatory reaction to asymptomatic or residual opportunistic infections may arise (immune reconstitution inflammatory syndrome, IRIS). Symptoms may include fever, lymph node swelling, and worsening of pre-existing infections such as tuberculosis, cytomegalovirus retinitis, or Pneumocystis pneumonia. Autoimmune disorders (such as Graves disease, polymyositis, and Guillain-Barré syndrome) have also been reported in the setting of immune reconstitution and may occur many months after treatment initiation.
Osteonecrosis: Cases of osteonecrosis (bone death due to loss of blood supply) have been reported in patients receiving antiretroviral combination therapy. Risk factors include long duration of combined antiretroviral therapy, corticosteroid use, alcohol consumption, severe immunosuppression, and higher body mass index. Patients should be advised to seek medical attention if they experience joint stiffness, aches, pain (particularly in the hips, knees, and shoulders), or difficulty with movement.
Pregnancy and Breastfeeding
A large body of data from exposed pregnancies (more than 1,000 first-trimester exposures in the Antiretroviral Pregnancy Registry) has not shown an increased risk of malformations associated with tenofovir disoproxil. Viread is included as a preferred agent in several international guidelines for the treatment of HIV during pregnancy, including those from the WHO, DHHS, and BHIVA. For pregnant women with hepatitis B, tenofovir may also be used to reduce the risk of mother-to-child transmission, particularly in women with high viral loads. Nevertheless, the decision to use Viread during pregnancy should always be made in consultation with a healthcare provider.
For HIV-infected mothers, breastfeeding is not recommended because the virus can be transmitted through breast milk. For mothers with hepatitis B only (not coinfected with HIV) whose infants have received appropriate hepatitis B immunoprophylaxis (vaccine and immunoglobulin at birth), breastfeeding may be considered after discussion with the treating physician, as the benefits of breastfeeding may outweigh the minimal additional risk of HBV transmission.
Never stop taking Viread without consulting your doctor first. Abrupt discontinuation can cause serious health consequences, especially severe hepatitis B flares in patients with HBV infection, or loss of HIV viral suppression leading to drug resistance and disease progression.
How Does Viread Interact with Other Drugs?
Because tenofovir is primarily eliminated by renal excretion through a combination of glomerular filtration and active tubular secretion, co-administration with drugs that reduce renal function or compete for active tubular secretion may increase concentrations of tenofovir or the co-administered drug, potentially leading to increased toxicity. It is essential that healthcare providers have a complete picture of all medications, supplements, and herbal products a patient is taking before prescribing Viread.
Major Interactions
Didanosine: Co-administration of tenofovir disoproxil with didanosine (another antiretroviral medication) increases the systemic exposure to didanosine by approximately 40–60%, which may increase the risk of didanosine-related adverse reactions including pancreatitis, lactic acidosis, and peripheral neuropathy. Reductions in CD4 cell count have also been observed. If this combination cannot be avoided, close clinical monitoring and a dose reduction of didanosine are necessary. In general, this combination is no longer recommended in current treatment guidelines.
Adefovir dipivoxil: Viread must not be co-administered with adefovir dipivoxil, as both drugs are nucleotide analogues that share the same renal transport pathway. Using them together provides no additional antiviral benefit but increases the risk of nephrotoxicity.
Other tenofovir-containing products: Viread must not be used concurrently with any other product containing tenofovir disoproxil or tenofovir alafenamide (TAF), as this would result in therapeutic duplication and an increased risk of adverse effects.
Nephrotoxic Medications
Concurrent use of Viread with other nephrotoxic agents should be avoided where possible. If co-administration is unavoidable, kidney function should be monitored weekly. Nephrotoxic drugs that require particular caution include:
| Interacting Drug | Category | Clinical Significance | Recommendation |
|---|---|---|---|
| Didanosine | Antiretroviral (NRTI) | Increases didanosine levels 40–60%; risk of pancreatitis, lactic acidosis, neuropathy | Avoid combination; if unavoidable, reduce didanosine dose and monitor closely |
| Adefovir dipivoxil | Antiviral (HBV) | Shared renal transport; increased nephrotoxicity risk | Contraindicated – do not co-administer |
| Aminoglycosides (e.g., gentamicin) | Antibiotic | Additive nephrotoxicity | Avoid if possible; monitor renal function weekly if combined |
| Amphotericin B | Antifungal | Additive nephrotoxicity | Monitor renal function weekly |
| Foscarnet, Ganciclovir, Cidofovir | Antiviral | Additive nephrotoxicity via renal tubular mechanisms | Monitor renal function weekly |
| Vancomycin, Pentamidine | Anti-infective | Additive nephrotoxicity | Monitor renal function weekly |
| NSAIDs (e.g., ibuprofen, naproxen) | Anti-inflammatory | May reduce renal perfusion and increase tenofovir levels | Use with caution; monitor renal function |
| Tacrolimus | Immunosuppressant | Additive nephrotoxicity | Monitor renal function closely |
| Ledipasvir/sofosbuvir | Hepatitis C antiviral | May increase tenofovir exposure, especially with boosted regimens | Monitor renal function; consider alternatives to boosted PI |
| Sofosbuvir/velpatasvir | Hepatitis C antiviral | May increase tenofovir exposure | Monitor renal function |
Hepatitis C Antivirals
Patients receiving Viread who are also being treated for hepatitis C should inform their doctor about their complete medication list. Direct-acting antivirals for hepatitis C, including ledipasvir/sofosbuvir, sofosbuvir/velpatasvir, and sofosbuvir/velpatasvir/voxilaprevir, can increase tenofovir plasma concentrations. This effect is particularly pronounced when Viread is used alongside a pharmacokinetic booster such as ritonavir or cobicistat. Increased tenofovir levels raise the risk of nephrotoxicity, and renal function should be monitored more frequently in these patients.
Viread should be taken with food (a meal or snack) to optimize absorption. Administration with a high-fat meal increases tenofovir bioavailability by approximately 40% compared with the fasted state. Taking Viread consistently with food helps maintain stable drug levels in the blood.
What Is the Correct Dosage of Viread?
Viread should always be taken exactly as prescribed by your doctor or pharmacist. The tablets should be swallowed whole with water and taken with food to optimize absorption. Consistent adherence to the prescribed dosing schedule is essential for maintaining effective antiviral suppression and preventing the development of drug resistance.
Adults
HIV-1 Infection (Adults)
Dose: 245 mg (one tablet) once daily with food.
Note: Viread must always be used in combination with other antiretroviral medications for HIV. It should never be used alone for HIV treatment. Your doctor will select the most appropriate combination based on your treatment history and resistance testing results.
Chronic Hepatitis B (Adults)
Dose: 245 mg (one tablet) once daily with food.
Note: Treatment duration is long-term. The optimal duration of therapy has not been definitively established. Discontinuation may be considered in certain patients who achieve sustained virological and serological responses (e.g., HBeAg seroconversion with sustained HBV DNA suppression), but only under close medical supervision due to the risk of hepatitis flares.
Children
Children Aged 6 to Under 12 Years (17 kg to <22 kg)
Dose: 123 mg (one tablet) once daily with food.
Note: The 123 mg tablets are specifically formulated for children in this weight range. The child's weight should be monitored regularly, as a change in weight may necessitate a different dosage or formulation. Children weighing 22 kg or more should receive the standard 245 mg tablet. For HIV, Viread is used in combination with other antiretroviral agents. For hepatitis B, Viread may be used as monotherapy.
Children and Adolescents Aged 12 Years and Older (≥35 kg)
Dose: 245 mg (one tablet) once daily with food.
Note: Same dosing as adults. Viread is not recommended for children under 6 years of age or weighing less than 17 kg due to insufficient data.
Elderly Patients
No dose adjustment is necessary for elderly patients based on age alone. However, since renal function tends to decline with age, kidney function should be carefully assessed before and during treatment. Dose adjustments may be required based on creatinine clearance values.
Renal Impairment
| Creatinine Clearance | Recommended Dosing | Monitoring |
|---|---|---|
| ≥50 mL/min | 245 mg once daily (no adjustment) | Standard monitoring |
| 30–49 mL/min | 245 mg every 48 hours | Enhanced renal monitoring |
| 10–29 mL/min | 245 mg every 72–96 hours | Close renal monitoring |
| <10 mL/min (no dialysis) | No recommendation; consider alternative treatment | Specialist supervision required |
| Hemodialysis patients | 245 mg every 7 days or after approximately 12 hours of dialysis | Administer after completion of dialysis session |
Missed Dose
If you miss a dose of Viread, take it as soon as you remember, provided it is within 12 hours of the usual time. If more than 12 hours have passed since the dose was due, skip the missed dose and take the next dose at the regular scheduled time. Do not take a double dose to make up for a forgotten tablet. If you vomit within one hour of taking Viread, take another tablet. If vomiting occurs more than one hour after taking the dose, there is no need to take a replacement tablet.
Overdose
If you take more Viread than prescribed, contact your doctor or nearest emergency department immediately. Keep the tablet container accessible so you can describe what was taken. There is no specific antidote for tenofovir overdose. Treatment is supportive and symptomatic. Tenofovir is efficiently removed by hemodialysis, with an extraction coefficient of approximately 54%, so hemodialysis may be considered in cases of significant overdose.
Stopping Viread without medical supervision can have serious consequences. In patients with hepatitis B, abrupt discontinuation has led to severe hepatitis flares, in some cases requiring hospitalization. In HIV-infected patients, stopping treatment allows viral rebound, potential development of drug resistance, and immune system deterioration. Always consult your healthcare provider before making any changes to your treatment.
What Are the Side Effects of Viread?
Like all medicines, Viread can cause side effects, although not everybody gets them. The side effects listed below are based on extensive clinical trial data and post-marketing surveillance. During HIV treatment, weight gain and increased levels of blood lipids and glucose may occur. These are partly linked to restored health and lifestyle, though there may also be a direct association with certain antiretroviral medications. Your doctor will test for these metabolic changes during routine follow-up visits.
Contact your doctor or go to an emergency department immediately if you experience deep rapid breathing, drowsiness combined with nausea, vomiting and abdominal pain (possible signs of lactic acidosis), or swelling of the face, lips, tongue, or throat (possible allergic reaction).
Very Common
- Diarrhea
- Vomiting
- Nausea
- Dizziness
- Rash
- Weakness (asthenia)
- Decreased blood phosphate levels (shown in tests)
Common
- Flatulence (gas)
- Loss of bone mineral density
- Elevated liver enzymes (shown in tests)
Uncommon
- Pancreatitis (inflammation of the pancreas causing abdominal pain)
- Proximal renal tubular damage (kidney tubule injury)
- Rhabdomyolysis (muscle breakdown)
- Muscle pain (myalgia)
- Muscle weakness
- Decreased blood potassium levels (shown in tests)
- Elevated blood creatinine (shown in tests)
Rare
- Lactic acidosis (excess lactic acid in blood – potentially life-threatening)
- Fatty liver (hepatic steatosis)
- Kidney inflammation (nephritis)
- Increased urination and thirst (diabetes insipidus)
- Kidney failure
- Softening of bones leading to pain and fractures (osteomalacia)
- Fanconi syndrome (kidney tubule disorder)
- Liver inflammation (hepatitis) causing abdominal pain
- Swelling of face, lips, tongue, or throat (angioedema)
Muscle breakdown, softening of bones, muscle pain, muscle weakness, and decreased blood potassium or phosphate levels may occur as a consequence of proximal renal tubular damage. If you experience persistent or worsening bone pain, muscle weakness, or any unexplained symptoms, inform your healthcare provider promptly so that appropriate laboratory testing and clinical evaluation can be performed.
Antiretroviral combination therapy for HIV may cause changes in body shape (lipodystrophy), elevated blood lipids (cholesterol and triglycerides), and increased blood glucose. These metabolic changes are monitored through routine blood tests. Your healthcare provider will advise on lifestyle modifications and, if necessary, additional medications to manage these changes.
How Should You Store Viread?
Viread should be stored in its original container with the lid tightly closed. Each bottle contains a desiccant (silica gel) packet or canister that must remain inside the bottle to protect the tablets from moisture. The desiccant must not be swallowed. No special temperature or humidity storage conditions are required beyond normal room temperature.
Keep Viread out of the sight and reach of children. Do not use the tablets after the expiry date printed on the bottle and carton. The expiry date refers to the last day of the stated month. Do not dispose of medicines via wastewater or household waste. Return unused or expired medicines to your pharmacist for proper disposal. These measures help protect the environment.
What Does Viread Contain?
The active substance in Viread is tenofovir disoproxil, present as tenofovir disoproxil fumarate. The 245 mg tablets contain 245 mg of tenofovir disoproxil (equivalent to 300 mg of tenofovir disoproxil fumarate and approximately 136 mg of tenofovir). The 123 mg tablets contain 123 mg of tenofovir disoproxil (as fumarate).
245 mg Tablets
The 245 mg film-coated tablets are light blue, almond-shaped, and engraved with “GILEAD” on one side and “4331” on the other. They are supplied in bottles of 30 tablets.
123 mg Tablets
The 123 mg film-coated tablets are white, triangular, approximately 8.5 mm in diameter, engraved with “GSI” on one side and “150” on the other. They are supplied in bottles of 30 tablets.
Inactive Ingredients
Tablet core: Microcrystalline cellulose (E460), pregelatinized starch, croscarmellose sodium, lactose monohydrate, and magnesium stearate (E572).
Film-coating: Lactose monohydrate, hypromellose (E464), titanium dioxide (E171), and glycerol triacetate (E1518). The 245 mg tablets additionally contain indigo carmine aluminium lake (E132).
Viread tablets contain lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency, or glucose-galactose malabsorption should not take this medicine. The sodium content is less than 1 mmol (23 mg) per tablet, meaning Viread is essentially sodium-free.
Frequently Asked Questions About Viread
Both TDF (Viread) and TAF are prodrugs of tenofovir, but they differ in how they deliver the active drug to cells. TAF is a newer formulation that achieves higher intracellular concentrations of tenofovir in target cells (such as lymphocytes and hepatocytes) while resulting in significantly lower plasma tenofovir levels. This means TAF has less impact on the kidneys and bones compared with TDF. However, TDF remains an effective and widely used antiviral, particularly where TAF is not available or affordable. The choice between them should be made by your healthcare provider based on your individual clinical situation.
Tenofovir disoproxil is a key component of pre-exposure prophylaxis (PrEP) for HIV prevention, but for PrEP it is typically used in combination with emtricitabine as a fixed-dose combination tablet (marketed as Truvada and generics). PrEP with tenofovir-emtricitabine has been shown to reduce the risk of sexual acquisition of HIV by up to 99% when taken consistently. Viread alone (without emtricitabine) is not recommended for PrEP. The WHO recommends tenofovir-based oral PrEP as part of a comprehensive HIV prevention strategy for people at substantial risk of HIV infection.
Treatment duration for chronic hepatitis B with Viread is generally long-term and potentially lifelong, particularly in patients who are HBeAg-negative or who have cirrhosis. Discontinuation may be considered in select HBeAg-positive patients who achieve sustained HBeAg seroconversion (loss of HBeAg and development of anti-HBe antibodies) with undetectable HBV DNA for at least 12 months. However, stopping treatment carries a risk of viral relapse and severe hepatitis flares, so the decision should only be made under specialist supervision with close follow-up monitoring.
For HIV, resistance to tenofovir can develop if the drug is not taken consistently or if it is used without adequate companion antiretroviral agents. The K65R mutation is the primary resistance mutation associated with tenofovir. For hepatitis B, tenofovir disoproxil has a remarkably high barrier to resistance, and no confirmed resistance mutations have been identified even after up to 8 years of continuous treatment in clinical studies. This makes tenofovir one of the preferred agents for long-term hepatitis B management.
Yes, tenofovir disoproxil is available as generic versions from multiple manufacturers, including Tenofovir disoproxil STADA, Tenofovir disoproxil Teva, Tenofovir disoproxil Accordpharma, Tenofovir Disoproxil Viatris, and Tenofovir disoproxil Zentiva, among others. Generic versions contain the same active ingredient and are required to demonstrate bioequivalence to the originator product. Through the Medicines Patent Pool and WHO prequalification, affordable generic tenofovir is available in many low- and middle-income countries, which has been instrumental in expanding access to HIV and hepatitis B treatment globally.
While there is no specific contraindication between Viread and alcohol, excessive alcohol consumption can worsen liver disease (particularly in patients with hepatitis B or HIV-HBV coinfection) and may increase the risk of hepatotoxicity and lactic acidosis. Alcohol can also impair medication adherence. Patients with hepatitis B should discuss alcohol consumption with their doctor. In general, moderate alcohol intake is advisable, but avoiding alcohol is recommended for patients with any degree of liver impairment.
References
- European Medicines Agency (EMA). Viread – Summary of Product Characteristics. Last updated 2024. Available at: ema.europa.eu
- U.S. Food and Drug Administration (FDA). Viread – Prescribing Information. Gilead Sciences, Inc. Last revised 2024. Available at: accessdata.fda.gov
- World Health Organization (WHO). Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for a Public Health Approach. 2024 Update. Geneva: WHO.
- European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the Management of Hepatitis B Virus Infection. Journal of Hepatology. 2024;80(2):431–507.
- Terrault NA, Lok ASF, McMahon BJ, et al. Update on Prevention, Diagnosis, and Treatment of Chronic Hepatitis B: AASLD 2018 Hepatitis B Guidance. Hepatology. 2018;67(4):1560–1599.
- British HIV Association (BHIVA). BHIVA Guidelines for the Treatment of HIV-1-Positive Adults with Antiretroviral Therapy. 2024 Update. Available at: bhiva.org
- Marcellin P, Gane E, Buti M, et al. Regression of Cirrhosis During Treatment with Tenofovir Disoproxil Fumarate for Chronic Hepatitis B: A 5-Year Open-Label Follow-Up Study. The Lancet. 2013;381(9865):468–475.
- World Health Organization (WHO). Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023. Tenofovir disoproxil is included as an essential medicine for HIV and hepatitis B.
Medical Editorial Team
Medical Content
iMedic Medical Editorial Team – Specialists in Infectious Disease and Clinical Pharmacology
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iMedic Medical Review Board – Independent panel following WHO, EMA, FDA, BHIVA, and EASL guidelines
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Last medical review: . Published: . This article adheres to the GRADE framework for evidence evaluation and follows international medical editorial standards.