tenofovir disoproxil fumarate + lamivudine + emtricitabine + efavirenz + calcium + vitamin D2

This investigational therapeutic intervention combines a standard-of-care antiretroviral therapy (ART) regimen with nutritional supplementation to mitigate bone mineral density (BMD) loss. Developed by Mahidol University and evaluated at Ramathibodi Hospital, the regimen consists of the nucleotide reverse transcriptase inhibitor tenofovir disoproxil fumarate (TDF), the non-nucleoside reverse transcriptase inhibitor efavirenz (EFV), and either lamivudine (3TC) or emtricitabine (FTC). This ART combination is supplemented with oral calcium carbonate and high-dose weekly vitamin D2 (ergocalciferol). The intervention specifically targets the accelerated bone turnover and significant BMD loss associated with the initiation of TDF-based ART in treatment-naïve HIV-infected adults. By providing essential minerals and promoting intestinal calcium absorption through vitamin D receptor activation, the supplementation aims to counteract the secondary hyperparathyroidism and altered bone metabolism frequently observed in patients receiving tenofovir.

Other names

TDF/3TC or FTC/EFV plus Calcium and vitamin D supplement