Gilead Sciences Inc., which has been accused of hiding side effects of Truvada, will soon introduce another expensive option to help prevent HIV infection in at-risk populations.

In 2016, the manufacturer of Truvada introduced Descovy, a prescription medication designed to be used with other HIV-1 medications to help control HIV-1 infection and decrease HIV-related illnesses. The U.S. Food and Drug Administration (FDA) just approved Descovy as a medication that can help reduce the risk of the transmission of HIV through sexual contact in men and transgender women who have sexual relations with men.

Descovy’s active ingredients are emtricitabine and tenofovir alafenamide (TAF).

Truvada, which will be available in generic form in the United States in September of 2020, contains emtricitabine and tenofovir disoproxil fumarate (TDF). Truvada has been available to treat HIV positive patients since 2004, and was approved as a preventive HIV drug in 2012 in the U.S.

Descovy or Truvada?

Some patient advocates say that not all patients will need to switch to the more expensive Descovy, but other patient advocates point to the risks associated with Truvada, even though it will be less expensive once it’s available in generic form.

According to the FDA, data from a phase 3 clinical study known as DISCOVER found that Descovy was non-inferior to Truvada in regards to safety and efficacy, but Descovy was reportedly less toxic to the kidneys and bones compared with Truvada.

According to Gilead’s Descovy website, Descovy side effects vary, but it may trigger acute worsening of hepatitis B in patients who have both HIV-1 and HBV, and that liver function should be closely monitored for a minimum of several months in patients with both diseases who discontinue Descovy.

Lawsuits Filed over Side Effects of Truvada

Even though both Truvada and Descovy contain emtricitabine, they each contain very different tenofovir drugs.

Truvada, which contains TDF, has been criticized for having a low bioavailability. Because of its poor absorption rate, a higher dose is needed in order for the drug to reach a therapeutic level in the patient’s body. Excess TDF may negatively impact the kidneys and bones, which Gilead allegedly knew, but failed to warn patients and doctors.

As a result, Gilead is facing Truvada lawsuits from patients who have suffered from bone problems and kidney issues that they allege they did not have prior to taking the HIV drug.

Fractures, loss of bone density, bone death (necrosis), osteopenia and osteoporosis have been reported among patients claiming adverse skeletal side effects from Truvada.

Kidney toxicity, chronic kidney disease, kidney damage and kidney failure are among the purported side effects of Truvada on the renal system.

Other medications that contain TDF include Atripla, Stribild and Complera.

Descovy’s TAF is the same tenofovir contained in Genvoya, a four-medicine combination pill that also contains elvitegravir, cobicistat and emtricitabine, all of which are used to treat and control HIV. Both Genvoya and Descovy are only available in brand name form from Gilead.

Gilead is headquartered in Foster City, Calif. and employs more than 10,000 people. The company reported revenue of more than $22 billion in 2018.