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Rovafovir etalafenamide is an investigational small molecule drug developed by Gilead Sciences for the treatment of HIV-1 infection. It is a nucleotide reverse transcriptase inhibitor (NRTI) and functions as a prodrug of GS-9148. Rovafovir etalafenamide itself has no antiviral activity; after administration, it undergoes hydrolysis to release the active antiviral compound GS-9148. The drug was designed to retain activity against HIV strains with major mutations conferring resistance to other nucleoside analog reverse transcriptase inhibitors commonly used in antiretroviral therapy[1][2][4]. Clinical development included trials in treatment-experienced adults with HIV, but further development was suspended after phase II due to insufficient antiviral response[4].
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