An isopropylalaninyl monoamidate phenyl monoester prodrug of tenofovir (GS 7340) was prepared, and its in vitro antiviral activity, metabolism, and pharmacokinetics in dogs were determined. The 50% effective concentration (EC 50 ) of GS 7340 against human immunodeficiency virus type 1 in MT-2 cells was 0.005 M compared to an EC 50 of 5 M for the parent drug, tenofovir. The (L)-alaninyl analog (GS 7340) was >1,000-fold more active than the (D)-alaninyl analog. GS 7340 has a half-life of 90 min in human plasma at 37°C and a half-life of 28.3 min in an MT-2 cell extract at 37°C. The antiviral activity (>10؋ the EC 50 ) and the metabolic stability in MT-2 cell extracts (>35؋) and plasma (>2.5؋) were also sensitive to the stereochemistry at the phosphorus. After a single oral dose of GS 7340 (10 mg-eq/kg tenofovir) to male beagle dogs, the plasma bioavailability of tenofovir compared to an intravenous dose of tenofovir was 17%. The total intracellular concentration of all tenofovir species in isolated peripheral blood mononuclear cells at 24 h was 63 g-eq/ml compared to 0.2 g-eq/ml in plasma. A radiolabeled distribution study with dogs resulted in an increased distribution of tenofovir to tissues of lymphatic origin compared to the commercially available prodrug tenofovir DF (Viread).Highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus is effective in reducing plasma viral loads below current assay detection limits and is responsible for significant reductions in AIDS-related mortality in the United States (13). Combinations of protease and reverse transcriptase inhibitors are extremely potent at blocking de novo infection; however, they have no effect on latently infected cells. The half-lives of these latent cellular reservoirs were originally estimated to be Ͼ3 years, leading to the conclusion that it may not be possible to eradicate human immunodeficiency virus (HIV) from an infected individual by using current HAART (2). It has subsequently been shown that even in patients who have undetectable plasma viremia (Ͻ50 copies/ ml), low-level replication is ongoing (11,15,36), resulting in repopulation of latent reservoirs and thus accounting for the long apparent half-lives observed (12,22,23,35). The failure of HAART to completely shut down virus replication in vivo is a function of both the intrinsic potency of the drug regimen and its distribution to the cellular sites of virus replication. The lymphatic tissues and the peripheral blood mononuclear cells (PBMCs) are the primary sites of virus replication and potential virus latency (9,19). A drug targeting strategy that selectively enhances active drug concentrations in these tissues without excessive systemic exposure is conceptually attractive and would potentially lead to a more effective HAART with fewer potential side effects.Tenofovir, {9-[(R)-2(phosphonomethoxy)propyl]adenine} (PMPA) (Fig.