HIV PrEP Treatment Increased Five-Fold From 2014 to 2017: Report

According to the findings of a new study, the daily use of the HIV PrEP drug Truvada for prevention of the infection increased by a factor of five from 2014 to 2017.

The U.S. Centers for Disease Control and Prevention (CDC) released a study this week, which looks at changes in HIV Preexposure Prophylaxis (PReP) among men who have sex with other men in 20 urban areas over a five year period. Those findings, published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) indicating that there has been a 500% increase in PReP prescriptions over that time period.

Truvada (emtricitabine/tenofovir disoproxil fumarate) was approved in 2004 for the treatment of HIV, and is also used as a PrEP HIV drug to prevent the spread of the disease among individuals at risk of contracting the infection. The HIV drug has generated billions in profits for Gilead, although the company now faces claims that it has withheld safer alternatives to increase profits.

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Kidney and bone injuries linked to the HIV drugs Truvada, Viread, Atripla, Complera and Stribild may have been avoided.

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In this latest study, CDC researchers with National HIV Behavioral Surveillance looked at data from 20 urban areas involving men who have sex with men (MSM). That group accounted for about 68% of new HIV infections in 2016. They interviewed 18,610 sexually active men.

According to the findings, awareness of PrEP increased among the men surveyed from 60% to 90% from 2014 to 2017. They also found that use of PrEP increased from only six percent among the group of men surveyed, to 35%; an increase of more than five-fold. However, the researchers said that despite the large increases, more needed to be done to put at-risk individuals on PrEP.

“Although PrEP use by MSM in this analysis increased approximately 500% from 2014 to 2017, only approximately one in three men at risk for HIV infection reported using PrEP. Models examining the impact of PrEP use on incidence predict that the use of PrEP by 30%–40% of MSM with PrEP indications in a community could result in approximately one third of new HIV infections being averted over a 10-year period, with a greater predicted impact if coverage is increased,” the researchers concluded. “The reported increase in PrEP use among MSM is promising, but higher coverage is needed to reduce incidence of new infections by 90% within the 10 years of the Ending the HIV Epidemic initiative.”

HIV Drug Litigation Concerns

The findings come amid growing concerns over Gilead’s stewardship of Truvada and other similar HIV medications that contain the antiviral tenofovir disoproxil fumarate (TDF), which has been used in a series of “cocktail” drugs introduced by the drug maker over the past few decades, including Viread, Truvada, Atripla, Complera and Stribild.

Gilead now faces a growing number of individual HIV drug lawsuits, alleging that side effects of the drugs caused serious kidney problems and bone fractures. Plaintiffs allege that the drug maker knew that an alternative design, involving tenofovir alafenamide fumarate (TAF), would allow delivery of the toxic drug at much lower doses, yet sat on the product for years to exhaust sales of TDF drugs during patent protection. It was not until Truvada and other TDF drugs were about to face competition from generic equivalents that Gilead resumed development of TAF drugs in 2015.

Several groups of plaintiffs have also filed  class action lawsuits over Truvada and other HIV drugs, alleging that Gilead and some other drug makers purposefully price-fixed Truvada and similar tenofovir disoproxil fumarate (TDF) medications in the United States.

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