Descovy

[SoCalBBversbttm]

I have been on PrEP for over two years.  I went from being a totally safe bottom to going to Cum Union parties and taking multiple loads.  I have also taken numerous Poz loads from guys - all without becoming HIV positive.  I do have a gay Doctor who is also an Infectious disease specialist.  He treated me for a handful of STD's all without judgement and we regularly talk about the kind of sex I have and the number of partners I have been.  During my last visit, he asked me generally how many partners I have been with over a three month period.  I gave him the average, as the double digit was high.  He then asked if I would be interested in participating in a new PrEP next gen drug, Descovy that he said would be better tolerated long term (kidneys and bone health).  Descovy is currently FDA approved as a Truvada replacement, but they are not sure over the long effectiveness for PrEP.  Does anyone have any anecdotal information on this drug and can you advise anything?  This will be a long term study (two + years and the study coordinator is contacting me.  Thanks.    

[fillmyholeftl]

From what I understand, the change in the formulation of Tenofovir  allows about a 10th amount of this drug without affecting the level of effective drug in your system.  Tenovir is thought to have to most negative effects on Kidneys & bone. They have put Descovy into 3 other combination therapies. I'm on one and don't feel that there is any less effectiveness in it. My ID doctor had no issue with switching me.

[rawfuckr]

The big thing about Descovy and PrEP, is that we DON'T know if it works as PrEP. 

 

It's easy to test TAF based Tenofovir formulations in people with HIV, but much harder to do efficacy studies on prevention, specially now we have Truvada PrEP.  TAF, the version of Tenofovir in Descovy, is metabolized different than Truvada's and it may make a different, with less concentrations of it where it matters, when it comes to prevention. We don't know yet.

 

Do you have happen to know how the study is going to be conducted? One arm with Truvada, another one with Descovy?

[SoCalBBversbttm]

Thanks for both of your replies.  I don't know how the study is going to be conducted yet.  I will post more information after I speak to the study coordinator.  

[SoCalBBversbttm]

I spoke with the study coordinator.  They relayed that the effectiveness of Descovy vs. Truvada has already been established as a PrEP replacement.  The study is looking at the toxicity levels on the kidneys and loss of bone density at different drug levels.  You will be given either a higher dose of Descovy or lower and measure the toxicity based on the drug strength that you take.  At both levels, the drug is still effective as a PrEP regimen.  It is a three year study.  The biggest downside right now is that you have to stop taking Truvada for 30 days before going on the trial.  That means either I will have to abstain, or gasp, use condoms again.  

[IAcollegeguy]

Not sure if this is the right place to post this, but recently a new technology called CRISPR was created that may end help end the HIV infection entirely.

 

 

We live in some interesting times.

[rawfuckr]

I spoke with the study coordinator.  They relayed that the effectiveness of Descovy vs. Truvada has already been established as a PrEP replacement.    

 

Is this true? AFAIK There have only been two studies related to TAF (Descovy) and PrEP and they are not too promising. One in monkeys did show Descovy protecting the animals from infection, but when they looked at concentrations of Tenofovir in people through TAF dosing, it was much less than expected, specially in rectal areas. Look at it here https://goo.gl/8eGcJW, But as far as gay breeding goes, this is what matters:

"Tenofovir concentrations in rectal tissue were about 10-fold lower with TAF than with TDF. Here, levels peaked by day 3 and remained detectable through the end of the 14-day study period. TFV-DP levels were undetectable in 63% of the rectal samples after TAF dosing but always detectable after TDF dosing"

 

TL;DR

TAF(Descovy) produces lower levels of Tenofovir in your butt which may mean less protection. Emphasis on 'may'

Edited September 21, 2016 by rawfuckr

[SoCalBBversbttm]

Interesting and thanks for the information. Let me present this to my Doc and see what he says. I will let you know.

[rawfuckr]

Interesting and thanks for the information. Let me present this to my Doc and see what he says. I will let you know.

 

I think part of the problem is that the actual mechanism why PrEP works are not completely understood. We know it works, we are not sure why. If it is because of Tenofovir concentration on PMBCs cells, then TAF/Descovy will be a fantastic agent for PrEP.