Descovy

Overall, Descovy is well tolerated, but some may experience nausea, headache, stomach pain, or changes in weight. New data associate INSTIs and TAF with weight gain; see article on page 8 and go to aidsinfo.nih.gov. Skin discoloration on palms and soles may also occur. May affect the bones and kidneys. In clinical trials, fewer bone and kidney issues were observed with the TAF formulation compared to the TDF formulation. Tell your provider about any pain in extremities, persistent or worsening bone pain and fractures, with or without muscular pain or weakness, as well as any concerning changes in urinary habits as these could be signs of kidney problems. If you have HIV and HBV, guidelines recommend treatment for both viruses. Descovy can be used to treat HIV and HBV simultaneously. If you are co-infected with HBV and HIV, you should not stop Descovy without medical supervision because it can cause your HBV to flare and cause you to experience signs and symptoms of acute hepatitis. HBV should be closely monitored by your provider.

Do not take with Epivir-HBV, Hepsera, or Vemlidy (TAF), used for the treatment of hepatitis B. Use caution with drugs that negatively affect the kidneys, including chronic use or high doses of anti-inflammatory drugs for pain like Advil or Motrin (ibuprofen) and Aleve (naproxen). Descovy should not be taken with certain anticonvulsants (including carbamazepine, oxcarbazepine, phenobarbital, and phenytoin), Aptivus/Norvir, rifabutin, rifampin, rifapentine, or St. John’s wort. Can be used with hepatitis C drugs such as Epclusa, Harvoni, or Zepatier. Tell your provider or pharmacist about all medications, herbals, and supplements you are taking or thinking of taking, prescribed or not, as there are other drug interactions which are not listed here.

Descovy is the newer version of Truvada. Instead of TDF, Descovy contains TAF (tenofovir alafenamide), which reduces serum tenofovir concentration by up to 90%. This results in a decreased impact on kidney and bone demineralization but maintains potent antiviral activity in the CD4 cell. In clinical trials, fewer kidney and bone issues were observed with TAF than with TDF, and significant improvements were observed when switching from TDF to TAF. The long-term impact of TAF on patients with osteopenia or osteoporosis is unknown. Both Descovy and Truvada are currently recommended by DHHS HIV treatment guidelines for first-time therapy for most people. Descovy received FDA approval in October 2019 for the prevention of sexually acquired HIV (pre-exposure prophylaxis, or PrEP) in adults and adolescents weighing at least 77 pounds, excluding individuals at risk from receptive vaginal sex, due to a lack of efficacy data in this population. It was studied in men who have sex with men and transgender women. See Descovy for PrEP page. Because both FTC and TAF are also active against hepatitis B (HBV), Descovy is recommended by DHHS for individuals co-infected with both HIV and hepatitis B. Pediatric HIV guidelines added Descovy last year as part of a preferred regimen. There is insufficient data in pregnancy for the DHHS to recommend the routine use of Descovy in pregnant women at this time. Descovy tablets are relatively small compared to Truvada and other combination tablets, which may be a plus for patients who have difficulty swallowing.

Dr. Ross Slotten says:

Approved in 2016 as a version of Truvada with a better safety profile (it contains TAF instead of TDF), Descovy has replaced Truvada as the A1 nucleoside backbone for most anti-retroviral treatment regimens today. It can be combined into a single tablet regimen (Genvoya, Biktarvy, Odefsey, and Symtuza) or prescribed as part of a two-tablet regimen with other PIs, NNRTIs and INSTIs. In October 2019, the FDA approved its use for PrEP (pre-exposure prophylaxis) after clinical trials demonstrated its equivalence to Truvada in preventing HIV infection. Because the risk of harmful effects on the kidney and bone density are significantly lower, Descovy no doubt will replace Truvada for PrEP.

Activist Bridgette Picou says:

Descovy is the newer version of Truvada. It is thought to be safer than the old formulation because of the change to the component tenofovir alafenamide fumarate, also called TAF, instead of the tenofovir disoproxil fumerate (TDF). With fewer bone and kidney effects, TAF is popular and already being used in several of the new single-tablet regimens. Descovy has also recently been approved for PrEP (see Descovy for PrEP page in this guide). It is also considered front line treatment as part of an HIV cocktail. There are some drug interactions to consider, and while blood and kidney effects are reduced, there is still a need to monitor. Discuss medications you take with your doctor and have your labs done consistently.