The primary difference between Truvada and Descovy is the form of tenofovir that makes up each medication. Truvada contains the original form of tenofovir, also known as tenofovir disoproxil fumarate, while Descovy contains the newer form known as tenofovir alafenamide. Both drugs are prescribed by health care professionals to reduce your risk of contracting HIV.
The Approval of Descovy
The FDA recently approved the use of Descovy for the prevention of the HIV virus — only the second drug to achieve this approval. While the drug did receive approval, the approval came with the explicit exclusion of individuals who engage in receptive vaginal sex. This means that the drug is not approved for use with cisgender women and many transgender men. There has yet to be a plan as to when it may be approved for this group of people.
The exclusion came about as the drug was only tested in men and transgender women, so until further testing is completed on cisgender women and other groups at risk for HIV, it will remain unapproved for use. Many activists support the exclusion because without further testing, researchers are unaware as to the effect it will have on vaginal tissue and if it will be different than rectal tissue.
Is Descovy Better Than Truvada?
While the use of a newer form of tenofovir may give patients the idea that Descovy is more effective than Truvada, there is nothing in any of the studies to indicate this. Both drugs are effective at preventing the contraction of HIV when taken daily. While researchers have discussed the fact that Descovy may have fewer side effects in reference to bone loss and renal complications, the findings have yet to be released in an official report.
Minor Side Effects of Descovy Use
There have also been minor side effects during trials in patients using Descovy. While most of these are more inconvenient than dangerous, they should be discussed with your health care provider if you experience them. Some of the more minor side effects include:
- Dark urine
- Pain in bones
- A decrease in the frequency of urination
- A decrease in appetite
- Faster breathing
- An increase in thirst
- Discolored stools
- Back and muscle pain
- Nausea and stomach cramping with or without vomiting
- Swelling in the extremities
- Body weakness
- Weight gain
- Yellowing of the eyes and skin
Possible Risks Associated With Descovy
There are some risks associated with the use of Descovy. One of the largest issues is its risk of exacerbating hepatitis B. If prescribed for patients with hepatitis B, it is recommended that health care providers closely monitor hepatic function and maintain regular laboratory followup in these individuals. To reduce the risks associated with Descovy, it is also recommended that patients be tested and treated for other STIs before beginning use.
Along with an HIV test, patients should be asked questions about recent possible exposure to HIV and possible symptoms that can indicate the presence of the virus that has not developed far enough for the test to detect. Possible symptoms of an HIV infection include:
- Flu-like symptoms
- Skin rashes
Possible Severe Side Effects
While severe side effects are rare, you should be monitored closely and report issues to your health care provider that could be linked to:
- Renal impairment: There have been cases reported of acute renal failure and Fanconi syndrome. Your doctor will likely check your creatinine clearance to ensure that your renal function is where it should be, especially if you are taking NSAIDs. If there is any evidence of a decrease in renal function, the use of Descovy should be discontinued.
- Lactic acidosis: Lactic acidosis or severe hepatomegaly with steatosis has been reported as a possible severe side effect with use. Your health care provider should monitor you for pronounced hepatotoxicity.
Gilead Patient Assistance Programs Are Available to Make Medication More Affordable
Gilead representatives have reiterated their desire to make their HIV medication available to those who need them. Since these medications come with such a significantly higher price tag, they have tried to address the affordability issue, removing the barriers that people often face to obtain the drug.
To aid patients, they have created a patient assistance program that provides those eligible through commercial insurance with a copay coupon program. For those who show a significant financial need, the medication may be free through the Medication Copay Assistance Program. They even offer an Uninsured 24/7 portal where patients can enroll for free medication through the system and be able to obtain their medication in a matter of hours instead of days. The final program that they offer is the Advancing Access program, which will help patients to obtain information from their insurance company about what coverages they can expect for Gilead products.
If you are at risk for contracting HIV, start the conversation about protecting yourself with a PrEP regimen.