Discovering Descovy

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06 Sep 2016

Descovy (pronounced des-koh-vee) is a once a day, fixed-dose regimen combining 200mg emtricitabine with 25mg tenofovir alafenamide — TAF for short. TAF is the new and improved formulation of tenofovir disoproxil fumarate — TDF.

Used in much lower doses than TDF (300mg), TAF is less harsh on the body: it’s kinder on the kidneys, and also has a softer impact on the kidneys and bones — both of which have become issues of concern as positive people age. (However, the drug’s producer, Gilead, still recommends the monitoring of bone density and kidney function in patients.)

Another selling point for the TAF component of Descovy is that, unlike TDF, TAF does not accumulate in the blood. It builds up inside the cells of the immune system instead. Meaning, as the immune system’s cells are attacked by HIV, the accumulation of TAF helps to protect the cells from infection. In already infected cells, TAF reduces the production of HIV when used in combination with other drugs.

The second fixed-dose pill containing TAF (after Genvoya), Descovy can be taken with or without food and is generally well-tolerated, with side effects mild and temporary. The most common being: headache, tiredness, nausea and diarrhoea. Rarer side effects — found in fewer than one percent of participants in clinical trials — include abdominal pain, indigestion, flatulence, rash and vomiting. Again, these side effects are generally mild and temporary.

If you are considering Descovy as a treatment option, tell your doctor if you have kidney disease or liver disease. Descovy is not suitable for people living with HIV coinfected with hepatitis B as it can acutely exacerbate already existing symptoms of hep B. You will also need to tell your doctor that you’re pregnant or if you’re breast-feeding.

While Descovy has been called Truvada 2.0, Gilead has not sought approval of the drug for PrEP as there have been no clinical trials of the tablet for that purpose. Although approved by the Therapeutic Food Administration for use alongside other antiretroviral drugs, Descovy remains unsubsidised. It’s currently before the Pharmaceutical Benefits Advisory Committee for approval; a decision is expected in October.