Only genisi has even hazarded a guess! She guessed in #msg-26775090 that the answer has to do with a food interaction. Actually, the answer does not have to do with food, but it does have something to do with something that has a lot to do with food!
wild guess, but perhaps the turnover of IDIX899 to its active metabolite occurs more efficiently in mildly lower pH, and Truvada patients tend to be acidotic?