Tenvir AF
✅ Manages HIV infection
✅ Reduces viral load
✅ Protects kidneys
✅ Decreases bone loss
✅ Improves quality of life
Tenvir AF contains Tenofovir Alafenamide.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
Quick Answer — Tenvir AF (Tenofovir Alafenamide 25 mg)
- Active ingredient: tenofovir alafenamide fumarate (TAF) 25 mg, oral tablet, taken once daily with food.
- Primary indication on this listing: chronic hepatitis B virus (HBV) infection in adults — long-term suppression with substantially less kidney and bone exposure than older TDF.
- Mechanism: nucleotide reverse-transcriptase inhibitor (NRTI). Same active metabolite as tenofovir disoproxil, but a different prodrug that releases tenofovir inside hepatocytes and lymphocytes.
- Versus TDF: ~90% lower plasma tenofovir, ~6–7× higher intracellular drug. Same antiviral potency. Lower risk of renal toxicity and bone mineral density loss.
- HBV efficacy: non-inferior to TDF for HBV DNA suppression at 96 weeks; significantly better renal and bone safety markers in head-to-head trials.
- HBV flare warning: severe acute exacerbation can occur on discontinuation. Never stop without specialist supervision.
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What Is Tenvir AF?
Tenvir AF is an oral tablet containing tenofovir alafenamide fumarate 25 mg (TAF), manufactured by Cipla. Each pack typically contains 30 film-coated tablets.
TAF is the second-generation prodrug of tenofovir, designed to fix the renal and bone toxicity issues seen with the older TDF (tenofovir disoproxil) prodrug. The originator brand is Vemlidy (Gilead, FDA-cleared for chronic hepatitis B in 2016). Same active drug as TDF, dramatically different pharmacokinetics.
What Is Tenvir AF Used For?
- Chronic hepatitis B (CHB) in adults — first-line oral antiviral, especially in patients with chronic kidney disease (CKD), osteoporosis, age > 60, or pre-existing TDF-related renal/bone toxicity.
- HIV-1 infection — component of combination regimens (most commonly co-formulated with FTC, dolutegravir or bictegravir, or rilpivirine). Not used as monotherapy in HIV.
- HIV pre-exposure prophylaxis (PrEP) — the TAF + emtricitabine combination (Descovy) is approved for PrEP in cisgender men and transgender women; TDF/FTC remains preferred for at-risk people who could become pregnant.
TAF is not used to treat hepatitis C, herpes viruses, or any non-retroviral / non-HBV infection.
Why TAF Instead of TDF?
TDF is rapidly hydrolysed in plasma to tenofovir, exposing the kidneys to high circulating drug levels for hours. TAF stays intact in plasma far longer because it is a more stable prodrug, and is preferentially activated by lymphocyte and hepatocyte intracellular esterases (cathepsin A, CES1). The net result:
| Marker | TDF 300 mg | TAF 25 mg |
|---|---|---|
| Plasma tenofovir AUC | High (reference) | ~90% lower |
| Intracellular TFV-DP in PBMCs | Reference | ~6–7× higher |
| eGFR decline at 96 wks (HBV) | Modest, dose-related | Significantly less |
| Hip + spine BMD change | Small reduction | Less reduction; sometimes recovery on switch |
| Lipid effect | Mildly favourable (lipid-lowering) | Mildly unfavourable (raises LDL/HDL) |
The lipid effect is the one trade-off. In patients with established cardiovascular disease, TDF may be preferred. For most HBV patients with renal or bone risk factors, TAF is the cleaner long-term option.
Dosage and How to Take Tenvir AF
- Chronic hepatitis B: one 25 mg tablet once daily with food.
- HIV (combination regimens): 25 mg if combined with non-boosted agents; 10 mg if combined with a CYP3A inhibitor (cobicistat, ritonavir).
Take with food — bioavailability rises by approximately 65% with a moderate-fat meal. Swallow whole. Missed doses: take as soon as remembered if within 18 hours; otherwise skip and resume the next scheduled tablet.
Renal-impairment dose adjustment: no adjustment required for CrCl ≥ 15 mL/min. Below 15 mL/min, only use in patients on chronic haemodialysis (TAF dosed after dialysis on dialysis days). TAF is not recommended in non-dialysis end-stage renal disease.
Hepatic impairment: no adjustment for mild or moderate; not recommended in decompensated cirrhosis (Child-Pugh C).
Side Effects
Common: headache (~10%), abdominal pain (~5%), fatigue, cough, nausea, back pain. Usually mild and self-limiting.
Less common but important:
- Lipid changes — expect modest rise in LDL-C, HDL-C, total cholesterol, and triglycerides. Recheck lipids at 3 and 12 months. Consider statin therapy if cardiovascular risk is elevated.
- Weight gain — HIV trials show several kg over 1–2 years on TAF-containing regimens vs TDF (regression of TDF’s mild lipid-lowering effect appears to drive part of this). Less established in HBV monotherapy.
- Lactic acidosis with severe hepatomegaly — rare NRTI class effect; stop on unexplained progressive abdominal pain, rapid breathing, severe fatigue.
- Severe acute hepatitis B exacerbation on stopping — same flare risk as TDF. Requires monitoring for at least 6 months after discontinuation.
Drug Interactions
- Strong P-gp inducers — rifampicin, rifabutin, carbamazepine, phenytoin, oxcarbazepine, St John’s wort — lower TAF exposure. Avoid co-administration.
- CYP3A inhibitors — cobicistat, ritonavir — significantly raise TAF exposure. Use the 10 mg form if co-administered with a boosted PI/INSTI regimen.
- Other nephrotoxic drugs — less of a concern than with TDF, but caution still advised with cidofovir, IV aminoglycosides, IV amphotericin B, high-dose NSAIDs.
- Other tenofovir-containing products — do not combine TAF with TDF, adefovir, or another TAF-containing product.
Who Should Not Take Tenvir AF?
- Known hypersensitivity to tenofovir alafenamide or any excipient
- Severe renal impairment (CrCl < 15 mL/min) not on chronic haemodialysis
- Decompensated cirrhosis (Child-Pugh C)
- Concurrent strong P-gp inducer where switching is not feasible
Storage
Store below 30°C in the original bottle with desiccant. Protect from moisture. Keep out of reach of children.
Frequently Asked Questions
Is Tenvir AF the same as Vemlidy?
Yes — same molecule (tenofovir alafenamide 25 mg), same indication (chronic hepatitis B), same once-daily dosing. Tenvir AF is Cipla’s licensed generic version. Vemlidy is the originator (Gilead).
If TAF is better, why does anyone still take TDF?
Several reasons: TDF has a 20-year safety database; TDF lowers LDL cholesterol slightly (TAF does the opposite); pregnancy data is more mature for TDF; and TDF is materially cheaper. For young patients without renal or bone issues, TDF remains a perfectly reasonable first-line choice. TAF is preferred when renal or bone safety matters most.
Can I switch from Tenvir (TDF) to Tenvir AF?
Yes, and many patients do, especially after years on TDF when small declines in eGFR or BMD become relevant. The switch is straightforward: stop TDF, start TAF the next day. Antiviral suppression is maintained because both deliver the same active metabolite. Renal markers usually improve within 3–6 months. Recheck eGFR, urine protein, phosphate at 3 months post-switch.
Will Tenvir AF cure my hepatitis B?
No oral antiviral cures HBV. Tenofovir alafenamide suppresses replication so completely that viral DNA usually becomes undetectable and liver inflammation resolves — but the cccDNA template inside hepatocytes is not eliminated. Around 1–3% of patients per year achieve functional cure (HBsAg loss). For most patients, treatment is long-term.
Should I expect weight gain on Tenvir AF?
HIV combination data show modest weight gain on TAF regimens vs TDF, of around 2–4 kg over 96 weeks. The effect is smaller in HBV monotherapy and is partly explained by reversal of TDF’s slight metabolic disadvantage. If weight gain is concerning, baseline lipid and glucose monitoring is reasonable.
Can I take Tenvir AF in pregnancy?
Pregnancy data for TAF is growing but is still less mature than for TDF. For HBV in late pregnancy (week 28+) to prevent vertical transmission, TDF is the preferred choice based on the larger safety database. If you are stable on TAF and become pregnant, discuss with your hepatologist before switching — the call depends on viral load, fibrosis stage, and trimester.
Is Tenvir AF active against HIV resistance mutations?
TAF and TDF have an identical resistance profile because they deliver the same active metabolite. Both retain activity against most thymidine-analogue mutations (TAMs) but are reduced in efficacy against the K65R reverse-transcriptase mutation. Resistance testing should guide regimen choice when available.
Do I need any blood tests before starting Tenvir AF?
Yes — baseline HBV DNA, HBeAg / anti-HBe, HBsAg, ALT/AST, full blood count, eGFR, urinalysis (proteinuria), serum phosphate, lipid panel, and HIV antibody/antigen test. Treatment monitoring then settles to every 3–6 months for stable patients.
Does Tenvir AF interact with statins, blood-pressure drugs, or contraception?
No clinically significant interaction with statins, ACE inhibitors, ARBs, beta-blockers, calcium-channel blockers, or hormonal contraception. The few real interactions are with strong P-gp inducers (rifampicin, anticonvulsants) and CYP3A boosters (cobicistat, ritonavir).
Where can I order Tenvir AF?
You can order Tenvir AF directly from MedsBase. We supply genuine Cipla stock with worldwide shipping. Treatment of chronic hepatitis B should be supervised by a hepatologist or gastroenterologist with HBV DNA, ALT, eGFR, and HBsAg/anti-HBs monitoring at appropriate intervals.
Disclaimer
The information on this page is for educational purposes and is not a substitute for professional medical advice. Treatment of chronic hepatitis B and HIV requires baseline workup, ongoing specialist monitoring, and individualised regimen choice. Do not start, stop, or switch tenofovir-based therapy without consulting a qualified clinician.
Tenvir-AF (TAF/FTC) handles HIV PrEP but does not cover bacterial STIs; if you’d like layered protection many users pair it with doxy-PEP — our PrEP Starter Pack (Tenvir-EM + doxycycline 100 mg) bundles the established TDF/FTC PrEP regimen with doxycycline for syphilis, chlamydia, and gonorrhoea prevention.
Patients on Tenvir AF for hepatitis B who also require HIV pre-exposure prophylaxis should note that Tenvir EM (tenofovir disoproxil fumarate 300 mg + emtricitabine 200 mg) is the approved dual-component PrEP regimen combining TDF with emtricitabine for comprehensive HIV prevention.
Clinics building ART formularies around Tenvir AF (tenofovir alafenamide 25 mg) as a renal-sparing backbone also stock Avonza (TDF / lamivudine / efavirenz) for cost-conscious patients in whom the older TDF formulation’s renal profile is clinically acceptable.
Patients tolerating Tenvir AF (tenofovir alafenamide 25 mg) but seeking a lower-cost daily PrEP option without the TAF/FTC premium may consider Tavin EM (tenofovir disoproxil 300 mg + emtricitabine 200 mg), the older TDF/FTC PrEP backbone with the largest evidence base.
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| Strength | 25 mg |
|---|---|
| Quantity | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
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