CDC makes controversial decision to urge daily pill for preventing HIV infection

The CDC began recommending daily medication with the anti-HIV pill Truvada as a means of pre-exposure prophylaxis, but some critics cite side effects, compliance challenges, and a potential relaxation on using existing forms prevention as concerns.

by John Tyburski

Copyright © Daily Digest News, KPR Media, LLC. All rights reserved.

First published at Daily Digest News on May 14, 2014

The U.S. Centers for Disease Control and Prevention (CDC) has endorsed a pharmaceutical pre-exposure prophylaxis, or PrEP, and is recommending its daily use by those at risk for getting human immunodeficiency virus, or HIV, the virus that causes Acquired Immune Deficiency Syndrome, or AIDS. The CDC recommends the pills be used by at-risk individuals in combination with other preventive methods such as condoms and regular HIV screening.

Truvada is recommended for people who do not have HIV and are at substantial risk for getting HIV through sexual transmission and injection drug use. Details for defining substantial risk are listed on the CDC’s PrEP online resource page. People who use Truvada must do so every day in order for the pills to work to their potential. The CDC recommends HIV screening and follow-up with a health care provider every three months.

An estimated 50,000 new HIV cases are reported each year, and there is no vaccine or cure now or expected in the foreseeable future. Since the mid-1990s, more people live with HIV because of the reduction of AIDS brought about by highly-active antiretroviral therapy, or HAART. An estimated 1.1 million people currently live with HIV in the U.S. Among these, almost 500,000 are eligible for PrEP.

The pills are marketed under the name Truvada by Gilead Sciences Inc. in Foster City, California, and consist of two active drugs, emtricitabine and tenofovir disoproxil fumarate. Fewer than 10,000 people are prescribed Truvada, which costs about $15,000 per year. The drug combination is sold worldwide and has generated approximately $3.1 billion in sales last year alone for Gilead.

Not all experts in the HIV/AIDS battle are supportive the CDC’s decision. Experts with the AIDS Healthcare Foundation (AHF), a Los-Angeles-based non-profit organization that provides health care to over 300,000 patients, worry that the push for PrEP may lead to a decline in condom use and subsequent increases in other sexually transmitted disease cases.

“This is a position I fear the CDC will come to regret,” said AHF president Michael Weinstein in a statement. Through this recommendation, ’’the CDC has abandoned a science-driven, public health approach to disease prevention—a move that will likely have catastrophic consequences in the fight against AIDS in this country,’’ he said.

The side effects reported for Truvada are bone weakness over time, upset stomach, loss of appetite, and renal issues in those with underlying metabolic conditions such as diabetes and hypertension.