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Truvada (emtricitabine, tenofovir) is an interesting medication with three primary applications: to prevent infection with HIV, to treat people who currently have HIV/AIDS, and to treat Hepatitis B virus (HBV). It is taken the same in all cases; one tablet per day, with or without food.

The medication can be used in children who weigh at least 37 pounds (17 kg), though in smaller doses; at the youngest end of the spectrum half of the standard dose is given. Patients weighing more than 77 pounds (35 kg) can take the full standard dose.

Truvada is a nucleoside reverse transcriptase inhibitor (NRTI), which blocks an enzyme called reverse transcriptase. In combination, the two active ingredients in the medication prevent HIV from multiplying and reduce levels of the virus in the body. It will not cure patients who already have HIV/AIDS.

Preventing HIV Infection with Truvada

As a preventative measure Truvada is known as PrEP (pre-exposure prophylaxis). The medication is useful in patients who do not currently have, but are at high risk of acquiring, HIV. This includes straight, gay, and bisexual individuals who regularly:

• Has unprotected sex with multiple partners;
• Has sex with a partner who engages in sex with multiple partners;
• Who does not have HIV but has a partner who does;
• Who uses, or has sex with a partner who uses, unclean needles.

PrEP is generally only prescribed after an HIV test has been administered. Somewhat less commonly, patients are also expected to combine treatment with risk-reduction counseling, correct & consistent condom use, regular HIV testing, and screening for (and treatment of, if found) other sexually transmitted diseases. It is less common than in the past that one's ability to get or refill a Truvada prescription is based on the attendance of such courses.

Truvada should be taken daily to prevent infection. It may be taken for as long as needed, provided no serious side effects develop. A condom should also be used.

Treating HIV/AIDS with Truvada

Patients who already have HIV/AIDS can also take Truvada, but it is always given along with other HIV medications. The standard dose is one tablet per day, taken with or without food as desired. Rarely a larger dose may be prescribed; more commonly less is, in individuals with kidney or liver damage.

The medication inhibits the virus from multiplying, slowing the progression of the disease. This action also helps the immune system retain its functionality longer, battling both the HIV/AIDS virus as well as other conditions the patient may acquire, though any other conditions should be brought to the attention of a doctor regardless.

It is in this application that the medication sees the most use in children; those born with the condition or who acquired it at a very young age can start taking the medication at 37 lbs (17 kg). A doctor should be consulted as to the best dosage, which will be calculated by weight and which other medications are being taken.

Managing Hepatitis B Virus

This is an off-label use for the medication, which is legal but there's little official information about it. It works similarly in preventing or treating HIV; it reduces levels of the virus in the body, which spares the liver from damage by the virus. It is a long-term treatment and treatment should not stop abruptly; doing so can cause the HBV infection to suddenly worsen.

Again a single tablet is typically taken once per day. Kidney function will need to be routinely evaluated.

Potential Complications

Truvada is well-tolerated by most patients, with side effects being mild and usually transient:

• Headache
• Nausea
• Stomach pain
• Vomiting
• Dizziness
• Insomnia
• Unusual dreams

More rarely, severe side effects can happen which warrant medical attention:

• Irregular heartbeat
• Joint pain
• Severe lower back pain
• Tremors
• Mental or mood changes
• Symptoms of new infections

Taking medications containing didanosine, cidofovir, albuterol, citalopram, atazanavir, acyclovir, and cholecalciferol can interfere with the effectiveness of one or more the drugs.