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Posted

https://www.nbcnews.com/feature/nbc-out/fda-backs-gilead-s-hiv-prevention-drug-descovy-use-prep-n1040416

 

So it appears that FDA recently approved a new drug called descovy for PrEP. but the FDA doesn't approve it for women !!! I am smelling some malignancy here. We know this President and his administration doesn't like LGBTs... Is it another step of him to trick us all into getting HIV and die off ? If descovy is really effective, why they don't approve it for women ( because they want women to be intact so that they can better serve as baby-producing-machine ? )  ?...The seheterosexual cisgender scums are definitely up to no good...Thoughts ? 

Posted

Men and women have different biological components and there are some medications that may work for males but not females or vice versa. This really isn't fishy at all.

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Posted

Truvada does not work as effectively for women as it does for men. Truvada builds up in the tissues of the rectum more than it does in the vagina. Apparently, the effect is more pronounced with descovy. 

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Posted

Ummmm exact opposite

Truvada trumps Descovy as far as PReP is concerned 

so when Truvada goes generic and they want to throw you on Descovy

be a smart patient and ask for Generic  Truvada over Descovy if u want the protection 

trust me ........

Posted
On 9/9/2019 at 4:40 AM, rawwhitebottom said:

Ummmm exact opposite

Truvada trumps Descovy as far as PReP is concerned 

so when Truvada goes generic and they want to throw you on Descovy

be a smart patient and ask for Generic  Truvada over Descovy if u want the protection 

trust me ........

Is Descovy not effective ? 

Posted

Based on the mechanisms of action of the two drugs, Truvada offers better protection theorerically. Haven't read the trials of Descovy used as Prep yet. If you don't have any kidney problems, I don't suggest switching to Descovy right away. Wait at least a few years first and see if Descovy is as good as Prep. If there are more incidences of people contracting the virus while they're on Descovy, then that's your answer for which drugs is better.

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Posted
On 9/19/2019 at 5:38 AM, koolocboy said:

Based on the mechanisms of action of the two drugs, Truvada offers better protection theorerically.

I'm not sure what your intended meaning here is, koolocboy, but the mechanisms of action of the two drugs are identical. The only difference is that the tenofovir in them is a different prodrug form, which affects the absorption and metabolism, but not the mechanism of action. Can you clarify what the theoretical advantage of Truvada is for use as PrEP?

Posted
On 9/20/2019 at 1:03 PM, viking8x6 said:

Can you clarify what the theoretical advantage of Truvada is for use as PrEP?

For sure, as you said, the difference between the two drugs are their prodrug forms of tenofovir, tenofovir disoproxil fumarate (TDF in Truvada) vs. tenofovir alafenamide (TAF in Descovy). Both of these prodrugs have no anti-HIV activities and must be metabolized to phosphonate tenofovir (TFV), which is potent against HIV, but also nephrotoxic and bone mineral density reducing. The difference in their metabolisms is what make TDF (Truvada) theoretically better for PreP. TDF is broken down to TFV when it enters the blood stream, while TAF can survive prolonged systemic exposure and get converted to TFV once it enters an infected target cell. Based on this difference, TFV is about 10x more concentrated in the blood if the person takes TDF (Truvada), which is theoretically favorable for someone who doesn’t have HIV, but was exposed and the virus just entered his/her body through blood. 

And please correct me if I am wrong. I had some trainings in infectious diseases but ID is not my field.

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Posted (edited)
22 hours ago, koolocboy said:

...TDF is broken down to TFV when it enters the blood stream, while TAF can survive prolonged systemic exposure and get converted to TFV once it enters an infected target cell. Based on this difference, TFV is about 10x more concentrated in the blood if the person takes TDF (Truvada), which is theoretically favorable for someone who doesn’t have HIV, but was exposed and the virus just entered his/her body through blood.

Great explanation, and your understanding of the prodrugs is right on target.

However, I think there's a flaw in your logic. Because of the mechanism of action of TFV (it inibits reverse transcriptase, the enzyme that translates the HIV RNA into DNA, which takes place *after* the virus has entered the cell and its RNA has started making proteins), it's only going to be effective after it is already in the cell that the HIV virus is infecting. So it really has to be in there already, which means that having TFV floating around in the blood *outside* the cell isn't going to help prevent infection. Just mess up your kidneys. This would be why Gilead developed TAF. I believe this is also the reason that it's necessary to build up the body level of either drug before exposure - it takes time for it to be absorbed and get into the cells where it is needed.

Infectious disease isn't my field either, but biochemistry is, or was once, with substantial studies in molecular bio as well.

Edited by viking8x6
Added last sentence to clarify expertise
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