There are many different types of HIV medications available. However, the two antiretroviral agents that are among the most commonly prescribed are Truvada & Descovy. For many years, Truvada was the only FDA-approved drug for pre-exposure prophylaxis, or PrEP, which is medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use. However, in October of 2019, Descovy also received FDA approval for PrEP.
Both drugs are manufactured by Gilead Sciences, Inc., and they also work in similar ways. In order for HIV to replicate, it needs to create DNA from building blocks called nucleotides. Truvada and Descovy both work by blocking something called the reverse transcriptase (RT) enzyme, which uses nucleotides to convert RNA to DNA. In this way, Truvada and Descovy are able to help prevent the formation of new viruses.
Although both Truvada and Descovy contain almost identical components, they have some differences in adverse effects, dosage, and indications. In 2015, Descovy was approved to treat children and adults with HIV-1 infections. Descovy is the brand name for the combination of emtricitabine (FTC) and tenofovir alafenamide (TAF). Truvada, on the other hand, is the brand name for the combination of emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF).TAF in Descovy has a higher plasma stability compared to TDF in Truvada. As a result, TAF is more potent with higher concentrations in HIV-infected cells. In addition, Truvada has been shown to have more adverse effects on kidney function and bone density when compared to Descovy.
Both Descovy and Truvada are used to treat HIV infections in combination with other drugs. Common combinations involve the integrase inhibitor Tivicay, or the protease inhibitor Prezista. Descovy or Truvada can also be used with a non-nucleoside reverse transcriptase inhibitor like Sustiva.
Descovy and Truvada can also be used for HIV prevention, or PrEP. For those who are at risk of HIV, Descovy or Truvada can be taken once daily to prevent HIV infection.
While both Descovy and Truvada are effective in treating and preventing HIV infections, Descovy, as the newer drug, is marketed as a safer and more effective option. This may be because it has a higher concentration in HIV-infected cells, while causing minimal repercussions on kidney and bone health.
Clinical trials have shown that the TAF in Descovy is just as effective as the TDF in Truvada. However, some studies have also shown that TAF in Descovy may also contribute to weight gain in some patients.
While both drugs are safe and effective, it is important to note that both drugs only work if taken consistently every day. Without proper adherence to the medication, the risk for HIV resistance increases. It’s important to discuss available HIV drugs with your healthcare provider to determine what treatment option is best for you.
While the average retail cost for both drugs is more than $2,000, these drugs are usually covered by either Medicare or most insurance plans. For those without insurance, assistance programs are available to help offset the costs.