HIV Drug Descovy May Increase Risk of High Blood Pressure: Study

The findings of a new study suggest side effects of Descovy and other newer HIV drugs may increase the risk of hypertension, which may require closer monitoring of patients’ blood pressure when compared to older medications.

Descovy is one of the newest of a line of HIV drugs marketed by Gilead both as treatment for those who have the disease, and as a prophylactic to avoid contracting it. In this latest study, Kaiser Permanente researchers focused on the newer drugs’ use for pre-exposure prophylaxis (PrEP) and published their findings on September 11 in JAMA Network Open.

The study comes at a time when Gilead faces a number of HIV drug lawsuits alleging that it withheld development of newer drugs like Descovy for years, and continued to market older versions that were more toxic to users bones and kidneys, to maximize profits while those older drugs were still under patent protections.

In the early 2000s, Gilead developed and introduced a line of HIV treatments based on the antiretroviral tenofovir disoproxil fumarate (TDF), including the blockbuster medications Truvada, Viread, Atripla, Complera and Stribild, which allowed the drug maker to create an essential monopoly over the U.S. HIV treatment market. However, lawsuits claim that Gilead knew about safer alternatives, involving the compound tenofovir alafenamide fumarate (TAF), which is used in Descovy and other newer treatments, allowing lower doses that are equally as effective at treating or preventing HIV.

Rather than fully warning about the risk of bone demineralization, bone fractures and other kidney side effects associated with the TDF-based drugs, plaintiffs indicate Gilead continued to sell the older drugs without accurate risk information, and delayed development of the safer alternative, until patent protections expired, further extending its monopoly of the HIV treatment market for decades.

In this latest study, researchers compared the risks of Descovy hypertension and whether patients had to be put on statins after beginning treatment. The researchers conducted a retrospective cohort study using Kaiser Permanente’s electronic health records data for southern California, looking at the incident hypertension and status initiation within two years of starting PrEP, among nearly 7,000 individuals who began taking the HIV drug between October 2019 and May 2022.

According to the findings, those taking the TAF-based drug were 64% more likely to develop hypertension than patients taking the older HIV drugs. In addition, Descovy use was linked to a 33% increased risk of statin initiation due to increased cholesterol concerns.

The risks significantly increased with the age of the patient, the researchers determined. They also found that those on Descovy had more significant weight gain than those taking the older TDF drugs, and TDF drug patients saw a greater reduction in total cholesterol.

The researchers suggested the increased weight gain and lipid-level changes linked to Descovy are likely responsible for the high blood pressure and cholesterol risks.

“In this study of people taking PrEP, TAF use was found to be associated with higher incident hypertension and statin initiation compared with TDF use, especially in those 40 years or older,” the researchers concluded. “Continued monitoring of blood pressure and lipids for TAF users is warranted.”

Kaiser Permanente researchers called for future studies with larger sample sizes and longer follow-up periods to provide more data for doctors to be able to make informed clinical decisions regarding the risks of Descovy as a PrEP option.