What is Truvada?

What is Truvada?

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Truvada: Definition?

Antiretroviral medications meant for Human Immunodeficiency Virus (HIV) prevention are gaining lot of attention. Pre-exposure prophylaxis (PrEP) is the most advanced biomedical addition to the HIV prevention toolbox.

Currently, the only FDA (Food and Drug Administration)-approved PrEP therapy is daily oral consumption of Truvada.

Truvada is a prescribed medication that is a fixed-dose combination of 2 antiretroviral drugs namely; emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF).

Pill bottle labeled Truvada, with blue Truvada pills. Truvada is a drug used to prevent the contraction of HIV.

There are other pharmaceutical formulations of tenofovir (Viread) in use for HIV treatment, but only tenofovir disoproxil fumarate is used in PrEP.

PrEP, is a game changer and an HIV prevention option. It is a daily medication that can reduce the chances of becoming infected with HIV by over 99% when taken as prescribed.

Truvada works by blocking an enzyme called reverse transcriptase, which HIV uses to copy its genetic material and reproduce. 

It is the only medication that is Food & Drug Administration (FDA) approved as PrEP for HIV negative individuals.

Truvada for PrEP

Out of 1.1. million at-risk U.S citizens, approximately 200,000 currently receive Truvada for PrEP. Truvada, when taken in combination with other anti-HIV medications, is used to treat HIV-1 infection in adults.

Truvada minimizes the risk HIV infection when used in combination with other prevention tools (safer sex practices) in:

  • People who are not infected with HIV infection
  • Men who are HIV-negative having sex with other males
  • Men who are HIV negative, but are at an increased risk of getting infected with the virus through sexual activity with infected partner
  • People who do not always use protection like condoms
  • Men-women sexual intercourse partners, in which one of the sex partners has HIV infection

Truvada Consists of Two Medicines Combined in One Tablet

  1. Tenofovir disoproxil fumarate, also termed as tenofovir DF
  2. Emtricitabine or FTC – These are combined in one tablet to help control the HIV infection. Truvada comprises of two antiviral drug ingredients termed as nucleoside (a structural subunit of nucleic acids) and nucleotide reverse transcriptase inhibitors (NRTI).
Graphic of molecules, showing how PrEP drug Truvada works.

When used with other HIV-1 medicines (HIV-1 is a type of HIV that leads to Acquired Immune Deficiency Syndrome) to treat HIV-1 infection.

Truvada may help:

  • Minimize the amount of HIV-1 infection in your blood. This is termed as “viral load.”
  • Increase the number of CD4+ (T) cells (a type of T cell that plays an important role in the adaptive immune system in your blood that help fight off other infections) This may help improve your immunity. This brings down your risk of death and infections that could be a result of your weakened immune system.

Now you can get the care you need from wherever you are—aka, your couch.


Does Truvada Cure HIV OR AIDS?

Truvada is not a cure for HIV or AIDS.

While taking Truvada, you may still develop infections or other illnesses associated with HIV infection. If you have HIV-1 infection (HIV-1 is the AIDS-causing virus), you must keep taking HIV-1 medicines to control HIV-1 infection and decrease HIV-related illnesses.

Because Truvada alone may not be sufficient to safeguard you from getting HIV, it is important that safer sex practices like use of condom is also considered while you are taking Truvada to minimize the risk of getting infected.

You must be HIV-negative to keep taking Truvada in order to minimize your risk of infection.

While taking Truvada, you must get tested for other STDs (sexually transmitted infections) such as syphilis and gonorrhea – bacterial infection usually spread by sexual contact. These infections make it easier for the virus to get inside your body.

What is PrEP?

PrEP currently refers to a combination pill containing 300 mg of TDF (tenofovir disoproxil fumarate) and 200 mg of FTC (emtricitabine, trade name Emtriva).  It minimizes the risk of HIV transmission.

Truvada and Descovy are the two brand names of PrEP.

PrEP works well if taken before sexual activity. So, it is PrEP means to prevent infection. So, people who are not HIV-positive can use PrEP as it would reduce the risk of them getting infected. PrEP medication involves a fixed-dose combination 2 of antiviral oral tablets.

The brand name for this is Truvada. Both tenofovir DF (TDF) and emtricitabine (FTC) have been widely used to treat HIV. The United States approved PrEP in 2012, with Europe following in 2016.

Who Would Benefit From Taking PrEP?

If you are HIV negative and don’t always use safe sex practices like condoms, then PrEP could minimize your risk of HIV. Other factors related to an increased risk of HIV include:

  • Sex between men, because it has a much higher instance of HIV transmission
  • A recent Sexually Transmitted Infection (especially syphilis or rectal infection)
  • Using recreational drugs used for chemsex (crystal meth, mephedrone and GHB
  • Recent requirement for PrEP
  • HIV positive partner is finding it difficult to be adhering to their HIV medications

Possible Side Effects 

Common side effects include:

  • Nausea
  • Diarrhea
  • Join pain
  • Stomach or abdominal pain
  • Headache
  • Sore throat
  • Vomiting
  • Discomfort in sleeping
  • Respiratory infections
  • High cholesterol
  • Weird and strange dreams
  • Mental/mood changes (depression/anxiety)
  • Fatigue
  • Dizziness
  • Sinus infection
  • Skin rash or itching
  • Loss of appetite
  • Back pain

Very serious side effects of Truvada

Build-up of lactic acid in your blood (lactic acidosis)

It is a serious medical condition and can lead to death. Symptoms of these conditions include; weakness, fatigue, unusual muscle pain, being short of breath or fast breathing, vomiting, nausea, stomach-area pain, cold or blue hands and feet, dizziness, light headedness and fast or abnormal heart beats.

Chronic liver problems

This again is a serious medical condition and symptoms include; skin or white part of the eyes turns yellow, dark “tea colored” urine, light colored stools, loss of appetite for several days or longer, nausea and, stomach area pain.

Worsening of hepatitis B (HBV) infection

If you are suffering from HBV and you take Truvada, your hepatitis condition will aggravate and become worse if you stop taking it.

Nephrogenic Diabetes Insipidus

Nephrogenic diabetes insipidus is a kidney condition that has been identified in people who take Truvada. In this condition, the kidneys malfunction and there is an increased and unusual urge to pass urine by a patient and this may result in dehydration.

Symptoms of nephrogenic diabetes insipidus can include:

  • Headache
  • Fatigue
  • Dizziness
  • Muscle pain
  • Dry skin
  • Weight loss
  • Decreased memory
  • Orthostatic hypotension (low BP resulting in dizziness upon standing)
Two men in a relationship. One is taking PrEP because his partner is HIV positive.

How to Get PrEP?

First, find a provider who is able to prescribe PrEP medication.

Your three main options for getting PrEP are:

Discuss with your medical practitioner about advantages, risks, adherence, and effectiveness of using Truvada.

Also, find out what other safer sex practices should be combined with this medicaiton to decrease your chance of getting HIV.

If you and your provider decide that Truvada is a good option for you, you will need to have a blood draw before starting. You will be tested for HIV and HBV (Hepatitis B). As well an evaluation of your kidneys.

  • You will need to visit a health center that provides primary care services.
  • Truvada for PrEP is available by prescription from healthcare providers, doctors, physician assistants and/or nurse practitioners
  • You will need to talk with a medical provider about your sexual health when you ask for Truvada for PrEP
  • Your healthcare provider or doctor may need to get pre-authorization to give you a prescription. That could include certain formalities like filling up some important paper work, some lab tests and preliminary investigation.
  • You will most likely not be able to walk away with medication at the initial visit
  • Many national plans and private health insurance plans (like Medicaid) cover the cost of Truvada for PrEP
  • When evaluating and calculating the expenses and health costs for PrEP treatment, remember that it’s not just the cost of the medication. Do calculate the costs involved in several lab tests meant for diagnosis and frequent visits.

Now you can get the care you need from wherever you are—aka, your couch.


Conclusion 

HIV infections are being reduced by advanced antiretroviral medications. The medications and treatments are dramatically preventing the virus transmission and decreasing the HIV rates in our communities. PrEP is an especially important new tool for boosting that drop.

Truvada PrEP in combination with other safer-sex practices like use of condom, is most effective in reducing the risk of becoming infected with HIV infection.

References

Rx List. Truvada. Accessed March 11, 2020 at https://www.rxlist.com/truvada-drug.htm#description.

Gilead. Gilead Sciences to Provide Free Truvada for PrEP® to Support U.S. Initiative to End the HIV Epidemic. Accessed March 11, 2020 at https://www.gilead.com/news-and-press/press-room/press-releases/2019/5/gilead-sciences-to-provide-free-truvada-for-prep-to-support-us-initiative-to-end-the-hiv-epidemic.

Centers for Disease Control and Prevention. Truvada Medication Information Sheet. Accessed March 11, 2020 at https://www.cdc.gov/hiv/pdf/PrEP_GL_Patient_Factsheet_Truvada_English.pdf.

Truvada. What is TRUVADA for PrEP®?. Accessed March 11, 2020 at https://www.truvada.com/what-is-truvada/understanding-truvada

WebMD. Truvada. Accessed March 11, 2020 at https://www.webmd.com/drugs/2/drug-91482/truvada-oral/details

AIDS Info. Emtricitabine / Tenofovir Disoproxil Fumarate. Accessed March 11, 2020 at https://aidsinfo.nih.gov/drugs/406/truvada/0/patient

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